Search results for: pictures of children

Authors: Muntanavadee Maytapattana

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This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.

Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children

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Authors: Athena Pedro, Laura Bradfield, Mike Dare, Zandile Bantwana, Ashley Nayman

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The purpose of the research was to explore mother’s unique experience and knowledge of mothering in the first 1000 day of their child’s life, from birth to age 2. The study used a qualitative research methodology with an exploratory research design. A sample of 12 mothers was used, comprising different racial backgrounds from low income areas in the Western Cape. The data was collected by means of semi-structured, in-depth interviews, which were transcribed verbatim, analysed using Braun’s and Clark’s (2006) six phases of thematic analysis. Some of the findings revealed that the mothers who participated in the study were consistently unable to feed their children and themselves due to profound and extreme situations of poverty, stress, and lack of infrastructural support. These mothers residing in low-income communities are not adequately supported both financially and socially and are often unable to meet the needs of their infants within the first 1000 days. Given the consequential nature of this period, it is imperative that mothers are able to access such support. Single mothers especially are in need of social and financial support. Appropriate interventions are required to assist mothers generally but more specifically, mothers who have children within the first 1000 days of life. By implementing appropriate interventions to address these needs, it will assist mothers to ensure optimal developmental growth of their children. This will positively impact the developmental trajectory of children in South Africa.

Keywords: caring, economic hardship, first one thousand days, mothers

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Authors: Sabrina M. Wang, Rameen Qamar, Fahad Manzar Qureshi, Laura La Chance, Nathan J. Kolla, Barna Konkolÿ Thege

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Elevated level of aggressive behaviour in children and youth can lead to impairments in family, social or academic functioning. The aim of the present study was to critically review the evidence on the effectiveness of nutritional supplements in reducing aggression in children and youth. The Cochrane Library, EMBASE, MEDLINE, ProQuest Dissertations & Theses, PsycINFO, and PubMed data bases were searched for relevant studies. Altogether, 22 studies met inclusion criteria; 13 investigated the effect of macronutrients (fatty acids and amino acids), 6 studies investigated the effect of micronutrients (vitamins and minerals), while 3 studies investigated a combination of macro and micronutrients. Out of the 22 studies, 7 reported a beneficial effect of nutritional supplementation (vitamins and minerals, essential fatty acids, or a certain combination of these). Eight studies did not report a significant beneficial effect of nutritional supplementation (essential fatty acids, vitamin D, and L-tryptophan), while 7 studies reported mixed effects (vitamin B6, essential fatty acids alone and in combination with vitamins and minerals, and carnitine). The results overall suggest that there may be a role for broad-range vitamin and mineral supplements in the treatment of aggression in youth and children.

Keywords: aggression, children, youth, nutritional supplementation, micronutrient, macronutrient

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Authors: Melih Cattik

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The present study investigate effectiveness of video modeling procedures on request an item behavior of children with ASD. Two male and a female children with ASD participated in the study. A multiple baseline across participant single-subject design was used to evaluate the effects of the video modeling procedures on request an item behavior. During baseline, no prompts were presented to participants. In the intervention phase, the teacher gave video model to the participant and than created opportunity for request an item to him/her. When the first participant reached to criterion, the second participant began intervention. This procedure continued till all participants completed intervention. Finally, all three participants learned to request an item behavior. Based upon findings of this study, it will make suggestions to future researches.

Keywords: autism spectrum disorders, video modeling procedures, request an item behavior, single subject design

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Authors: Tryastuti I. B. Manullang, Juang Sunanto

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This study aimed to find the perspectives of the Toba Batak education stakeholders towards the education of children with disabilities in Toba Samosir North Sumatra Indonesia. The education stakeholders consist of a head of the education department in Toba Samosir, head of the H foundation, two principals and three teachers from the Special Primary Schools. This study uses qualitative a descriptive approach and research data obtained through interviews. The results of this study demonstrate that the education stakeholders knowledge about disabilities needs improvement in accordance with the development of science. The cultural views towards disability and its implications, and the education services available for children with disabilities, in addition, to encountered its problem in Toba Samosir are known. The education concept considered appropriate is the special school and the CBR (Community Based Rehabilitation) strategy, also inclusive education because it represents the Toba Batak philosophy.

Keywords: community based rehabilitation, education concept, education stakeholders, inclusive education

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric obesity indices such as waist circumference (WC), indices derived from anthropometric measurements such as waist-to-hip ratio (WHR), and indices created from body fat mass composition such as trunk-to-leg fat ratio (TLFR) are commonly used for the evaluation of mild or severe forms of obesity. Their clinical utilities are being compared using body mass index (BMI) percentiles to classify obesity groups. The best of them is still being investigated to make a clear-cut discrimination between healthy normal individuals (N-BMI) and overweight or obese (OB) or morbid obese patients. The aim of this study is to derive a new index, which best suits the purpose for the discrimination of children with N-BMI from OB children. A total of eighty-three children participated in the study. Two groups were constituted. The first group comprised 42 children with N-BMI, and the second group was composed of 41 OB children, whose age- and sex- adjusted BMI percentile values vary between 95 and 99. The corresponding values for the first group were between 15 and 85. This classification was based upon the tables created by World Health Organization. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements were taken and recorded following a detailed physical examination. Within this context, weight, height (Ht), WC, hip C (HC), neck C (NC) values were taken. Body mass index, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. Trunk-to-leg fat ratio, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2) were calculated. Fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis of the data was performed. Significantly increased values of (WC+HC)/2, (TF+LF)/2, D2I, and FMI were observed in OB group in comparison with those of N-BMI group. Significant correlations were calculated between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I as well as FMI both in N-BMI and OB groups. The same correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I, and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I as well as FMI in N-BMI group. Same correlations were observed also with TAFR. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. From these findings, it was concluded that (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index. The only correlation valid in both groups was that exists between (WC+HC)/2 and (TF+LF)/2. This index was suggested as a link between anthropometric and fat-based indices.

Keywords: children, hip circumference, obesity, waist circumference

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: Emran M. Badghish

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Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

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Authors: Željka Rogač, Dejan Stevanović, Sara Bečanović, Ljubica Božić, Aleksandar Dimitrijević, Dragana Bogićević, Dimitrije Nikolić

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Children with epilepsy face changes in cognitive functioning, the appearance of symptoms of psychopathology and a decline in their quality of life. Factors related to epileptic seizures and the side effects of AEDs are considered to be potential causes of these changes.These changes can be prevented by prompt action, replacement of AEDs, psychological and psychiatric treatment, and social support. However, a review of literature has not yielded a conclusion as to when it is best to react, i.e., when changes in the functioning of children with newly-diagnosed epilepsy appears. The primary goal of this study was to investigate the impact of the most commonly used AEDs on cognitive status, behavior, anxiety and depression, as well as quality of life of children with newly-diagnosed epilepsy, during the first six months of treatment. This is a non-interventional, prospective study involving six-month monitoring of cognitive status, internalizing and externalizing symptoms, as well as quality of life of children with newly-diagnosed epilepsy, and the impact of antiepileptic drugs on these domains. Children with new-onset epilepsy and their parents, immediately after the introduction of antiepileptic drugs as well as six months later, filled out appropriate questionnaires (RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP). At the same time, a psychologist performed the psychological testing of the child (REVISK). At the very beginning of REVISK treatment, a reduced VIQ was established, while after six months there was a significant decrease in IQ, VIQ and especially PIQ, under the influence of primary cognitive potentials and the development of depressive symptoms. All scores of the RCADS and NCBFR questionnaires were significantly elevated after six months while internalizing and externalizing symptoms affected each other. The development of depressive symptoms was significantly influenced by AED. The scores of the CHEQOL25 and KIDSCREEN10 questionnaires were significantly reduced, influenced by the adverse effects of AED and quality of life at the start of treatment. Side effects of AEDs, were significantly associated with depressive symptoms and reduced quality of life and did not significantly affect cognitive decline, anxiety, ADHD, and behavioral disorders during the first six months.

Keywords: epilepsy, children, AEDs, cognition, behavior, ADHD, anxiety, depression, QOL

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Authors: Aliya K. Salahova

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Scientific thinking is a fundamental cognitive skill that plays a crucial role in preparing young minds for an increasingly complex world. This study explores the connection between scientific thinking and the ability to ask questions in children aged 5-9. The research aims to identify and assess how questioning ability serves as an indicator of scientific thinking development in this age group. A longitudinal investigation was conducted over a span of 240 weeks, involving 72 children from diverse backgrounds. The participants were divided into an experimental group, engaging in weekly STEM activities, and a control group with no STEM involvement. The development of scientific thinking was evaluated through a comprehensive assessment of questioning skills, hypothesis formulation, logical reasoning, and problem-solving abilities. The findings reveal a significant correlation between the ability to ask questions and the level of scientific thinking in children aged 5-9. Participants in the experimental group exhibited a remarkable improvement in their questioning ability, which positively influenced their scientific thinking growth. In contrast, the control group, devoid of STEM activities, showed minimal progress in questioning skills and subsequent scientific thinking development. This study highlights the pivotal role of questioning ability as a key indicator of scientific thinking in young children. The results provide valuable insights for educators and researchers, emphasizing the importance of fostering and nurturing questioning skills to enhance scientific thinking capabilities from an early age. The implications of these findings are crucial for designing effective educational interventions to promote scientific curiosity and critical thinking in the next generation of scientific minds.

Keywords: scientific thinking, education, STEM, intervention, psychology, pedagogy, collaborative learning, longitudinal study

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Authors: Priyanka V. Janbandhu, Santosh B. Phad, Dhananjay W. Bansod

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The current changing scenario of the family is a compelling aged group not only to be alone in a nuclear family but also to join the old age institutions. The consequences of it are feeling of neglected or left alone by the children, adding a touch of helpless in the absence of lack of expected care and support. The accretion of all these feelings and unpleasant events ignite a question in their mind that – who is there for me? The efforts have taken to highlight the issues of the elderly after joining the old age home and their perception about the current life as an institutional inmate. This attempt to cover up the condition, adjustment, changed lifestyle and perspective in the association with several issues of the elderly, which have an essential effect on their well-being. The present research piece has collected the information about institutionalized elderly with the help of a semi-structured questionnaire. This study interviewed 500 respondents from 22 old age homes of Pune city of Maharashtra State, India. This data collection methodology consists of Multi-stage random sampling. In which the stratified random sampling adopted for the selection of old age homes and sample size determination, sample selection probability proportional to the size and simple random sampling techniques implemented. The study provides that around five percent of the elderly shifted to old age home along with their spouse, whereas ten percent of the elderly are staying away from their spouse. More than 71 percent of the elderly have children, and they are an involuntary inmate of the old age institution, even less than one-third of the elderly consulted to the institution before the joining it. More than sixty percent of the elderly have children, but they joined institution due to the unpleasant response of their children only. Around half of the elderly responded that there are issues while adjusting to this environment, many of them are still persistent. At least one elderly out of ten is there who is suffering from the feeling of loneliness and left out by children and other family members. In contrast, around 97 percent of the elderly are very happy or satisfied with the institutional facilities. It illustrates that the issues are associated with their children and other family members, even though they left their home before a year or more. When enquired about this loneliness feeling few of them are suffering from it before leaving their homes, it was due to lack of interaction with children, as they are too busy to have time for the aged parents. Additionally, the conflicts or fights within the family due to the presence of old persons in the family contributed to establishing another feeling of insignificance among the elderly parents. According to these elderly, have more than 70 percent of the share, the children are ready to spend money indirectly for us through these institutions, but not prepared to provide some time and very few amounts of all this expenditure directly for us.

Keywords: elderly, old age homes, life style changes and adjustment, India

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Authors: April Mattix Foster, Kathleen A. Ramos, Sarah Rich, Rebecca Eisenberg, Lisa Dornan

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As the number of children from immigrant and refugee backgrounds in our schools continues to grow, the need to cultivate antiracist educators is crucial. This e-poster outlines the design of online university course modules, funded by the Longview Foundation, designed to support pre- and in-service educators in developing great awareness of, empathy for, and advocacy with immigrant and refugee students in the classroom. These modules guide educators in using children’s and adolescent literature that highlights the lived experiences of immigrant and refugee families, utilizing scaffolded reading and thinking protocols as a model for encouraging empathy and global competence in young learners. Educators reported several benefits of using the modules and curated literature, including greater awareness of the significance of diverse literature, deeper self-reflection and empathy, and stronger connections to classroom practice—ultimately benefiting both educators and their students.

Keywords: antiracist, children’s literature, global competence, empathy, self-reflection

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Authors: Deepak Jugran, Rajesh Gill

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Purpose: To study the demographic, sociological, gender and clinical profile of the children presented for childhood cataract at a public sector tertiary eye care centre in India. Methodology: The design of the study is retrospective, and hospital-based data is available with the Central Registration Department of the PGIMER, Chandigarh. The majority of the childhood cataract cases are being reported in this hospital, yet not each and every case of childhood cataract approaches PGI, Chandigarh. Nevertheless, this study is going to be pioneering research in India, covering five-year data of the childhood cataract patients who visited the Advanced Eye Centre, PGIMER, Chandigarh, from 1.1.2015 to 31.12.2019. The SPSS version 23 was used for all statistical calculations. Results: A Total of 354 children were presented for childhood cataract from 1.1.2015 to 31.12.2019. Out of 354 children, 248 (70%) were male, and 106 (30%) were female. In-spite of 2 flagship programmes, namely the National Programme for Control of Blindness (NPCB) and Aayushman Bharat (PM JAY) for eradication of cataract, no children received any financial assistance from these two programmes. A whopping 99% of these children belong to the poor families. In most of these families, the mothers were house-wives and did not employ anywhere. These interim results will soon be conveyed to the Govt. of India so that a suitable mechanism can be evolved to address this pertinent issue. Further, the disproportionate ratio of male and female children in this study is an area of concern as we don’t know whether the prevalence of childhood cataract is lower in female children or they are not being presented on time in the hospital by the families. Conclusion: The World Health Organization (WHO) has categorized Childhood blindness resulting from cataract as a priority area and urged all member countries to develop institutionalized mechanisms for its early detection, diagnosis and management. The childhood cataract is an emerging and major cause of preventable and avoidable childhood blindness, especially in low and middle-income countries. In the formative years, the children require a sound physical, mental and emotional state, and in the absence of either one of them, it can severely dent their future growth. The recent estimate suggests that India could suffer an economic loss of US$12 billion (Rs. 88,000 Crores) due to blindness, and almost 35% of cases of blindness are preventable and avoidable if detected at an early age. Besides reporting these results to the policy makers, synchronized efforts are needed for early detection and management of avoidable causes of childhood blindness such as childhood cataract.

Keywords: childhood blindness, cataract, Who, Npcb

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Authors: Rahul Kumar

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Background: Under-FiveMortality Rate(U5MR)ofanationiswidelyacceptedandlong-standing indicators of well-beingofherchildren.They measuredtheprobability of dying before theageoffive(expressedper1000livebirths).TheU5MRisanappropriate indicator of the cumulative exposure totheriskofdeathduringthefirstfiveyearsoflife, and accepted globalindicator ofthehealthandsocioeconomicstatusofagiven population.Itisalsousefulforassessing theimpactofvariousintervention programmes aimed at improving child survival.Under-fivemortalitytrendsconstitutealeadingindicatorofthelevel ofchildhealthandoveralldevelopmentincountries. Objectives: The first aim of our research is to study the level, trends, and Pattern of Under-five mortality using different sources of data. The second objective is to examine the survival pattern of Under-five mortality by different background characteristics. Data Source and Methodology: SRS and NFHS data have been used forobservingthelevelandtrendofUnder-Five mortality rate. Kaplan Meier Estimate has been used to understand the survival Pattern of Under-five mortality. Result: WefindthatallmostallthestatesmadesomeprogressbyreducingU5MRin recent decades.During1992-93highestU5MR(per thousand live birth) was observed in Assam(142)followed by up(141),Odisha(131),MP(130),andBihar(127.5).While the least U5MR(perthousandlive birth)wasobservedinRajasthan(102). The highestU5MR(per thousandlive birth)isobservedinUP(78.1), followed by MP(64.9)and Chhattisgarh(63.7)which are far away from the national level(50). Among them, Uttarakhand(46.7)hadleastU5MR(perthousandlivebirth), followed by Odisha(48.6). TheU5MR(perthousandlivebirth)ofcombinedhighfocusstateis63.7whichisfar away fromthenationallevel(50). Weidentified thatthesurvivalprobability ofunder-fivechildrenfromadolescentmotherislessin comparisontootherchildrenbornby differentagegroupofmothers. thatduringneonatalperiodusually male mortality exceedsthefemale mortality butthisdifferentialreversedinthepostneonatalperiod. Astheirageincreasesand approachingtofiveyears,weidentifiedthatthesurvivalprobability ofbothsexdecreasesbut female’s survival probabilitydecrement is more than male as their ageincreases. The poorer children’s survival probability is minimum. Children using improved toilet facility has more survival probability throughout thefiveyearsthan who uses unimproved. The survival probability of children under five who got Full ANCis more than the survival probability of children under five who doesn’t get any ANC. Conclusions: Improvement of maternal education is an urgent need to improve their health seeking behavior and thus the health of their children. Awareness on reproductive health and environmental sanitation should be strengthened.

Keywords: under-five mortality, survival pattern, ANC, trend

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Authors: Natalia Kasatkina

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In an ever-increasing globalization, one’s grasp of diversity and tolerance has never been more indispensable, and it is a vital duty for all those in the field of foreign language teaching to help children cultivate such values. The present study explores the role of DIVERSITY and TOLERANCE in the language classroom and elementary, middle, and high school students’ perceptions of these two concepts. It draws on several theoretical domains of language acquisition, cultural awareness, and school psychology. Relying on these frameworks, the major findings are synthesized, and a paradigm of teaching tolerance through language-teaching is formulated. Upon analysing how tolerant our children are with ‘others’ in and outside the classroom, we have concluded that intolerance and aggression towards the ‘other’ increase with age, and that a feeling of supremacy over migrants and a sense of fear towards them begin to manifest more apparently when the students are in high school. In addition, we have also found that children in elementary school do not exhibit such prejudiced thoughts and behavior, which leads us to the believe that tolerance as well as intolerance are learned. Therefore, it is within our reach to teach our children to be open-minded and accepting. We have used the novel ‘Uncle Tom’s Cabin’ by Harriet Beecher Stowe as a springboard for lessons which are not only targeted at shedding light on the role of language in the modern world, but also aim to stimulate an awareness of cultural diversity. We equally strive to conduct further cross-cultural research in order to solidify the theory behind this study, and thus devise a language-based curriculum which would encourage tolerance through the examination of various literary texts.

Keywords: literary text, tolerance, EFL classroom, word-association test

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Authors: Dewi Hapsari Ratna Muninggar, M. Rizal Martua Damanik

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The purpose of this study was to develop a formulation of instant Indonesian traditional pancake (Surabi) based on composite rice and soybean flour and supplemented with Torbangun (Coleus amboinicus Lour) powder as an alternative snack for ADHD (Attention Deficit Hyperactivity Disorder) children. Completely randomised factorial design by two factors which were the ratio of composite rice and soybean flour (75:25; 70:30; 65:35) as well as the addition of Torbangun powder (3%; 5%; 7%) was used in this study. This study revealed that the best formula was instant surabi with 65:35 composite rice and soybean flour and 5% addition of Torbangun powder by considering hedonic test result, functional aspect and nutrients contribution. Then, both chemical and physical characteristics from the best formula of instant surabi were measured. Nutrients content of the chosen instant surabi per 100 g wet basis were 62.68 g moisture, 1.30 g ash, 6.81 g protein, 0.75 g fat, 28.47 g carbohydrate, 88.62 mg calcium, 4.14 mg iron, and 144 kcal energy while physical characteristics, such as water activity, cohesiveness, and hardness were 0.97, 0.569, 5582.2 g force consecutively. The results of this research suggested that instant surabi which can be possibly beneficial for ADHD children had 65:35 for rice and soybean flour ratio as well as 5% for the addition of Torbangun powder.

Keywords: ADHD children, instant surabi, soybean, torbangun

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Authors: Hina Abdul Majeed

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The story has a powerful impact on the human mind of all age groups. There are various ways to tell stories; one of the forms is digital storytelling. Digital storytelling is getting popular nowadays; it mainly catalyzes a child's holistic development in the early years. Thus, this study's primary purpose is to explore parents' perception of the impact of digital storytelling on developing children's moral values and the change that occurs in child's moral behavior and attitude using the digital storytelling tool. Literature was reviewed by exploring the recent studies on digital stories and their impact on child's development. This study was based on a mixed-method approach, considering qualitative and quantitative research designs. The population for this study included parents of early years children who resided in Karachi. However, parents of two to six years old children were targeted as samples by selecting using a purposive sample method. Thus, 100 parents were chosen for the quantitative survey, and five parents were interviewed to collect qualitative data. Questionnaires were developed for collecting data from parents through surveys and interviews. The SPSS was used to analyze the quantitative data, and the parents' responses collected during discussions were presented in narrative form. The findings show that the impact of digital storytelling, in most parents' opinion, is positive in inculcating moral values in their children. Moreover, parents also endorse the changes in child's behavior and attitude due to digital stories.

Keywords: digital storytelling, moral development, early years, parents

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Authors: Sharon Campbell-Phillips, Serlange Campbell, Daneil Phillips

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Students attending secondary schools in Tobago are said be spending a lot of time watching television and are falling back in their school work, and they are displaying violent behaviour. Violence is on the increase within the secondary schools in Tobago; therefore, the purpose of this study is to investigate if there is a relationship between television violence and persons ’behaviour. We are living in an age where information is readily available and easily accessible throughout the world and it allows us to broaden our horizon academically and otherwise. This is very possible because of social media, which is the largest platform in which persons can socialize, get information and gain knowledge, and there are many sites to choose from depending on their interest. However, despite the good and valuable information that persons can acquire, there are the promotion of violence which is also accessible. To gather information for this study, questionnaires were administered to students attending secondary schools in Tobago and teachers and parents were interviewed. The findings were carefully analyzed and aim to assist in dealing with violent behaviour among school children, and with recommendations for future research.

Keywords: media, violence, television, school children

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Authors: Felicia Titilayo Olanrewaju

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Folktales are a subclass of folklores which are verbally told and passed down from one generation to another, from the elderly ones to their children, usually at moonlight. These tales are heavily laden with moral lessons of what should be done and what not within the society. Though these are oftentimes heavily embellished yet are related to guide, guard, train, and dishing out moral attributes and mores worthwhile for ethical progression of the young minds within our traditional settings. With the rapid advancement of technological know-how, the existence of most of these moral-inclined stories becomes questionable; hence this study appraised the influences of these traditional storytellings have in the upgrading of moral learning of ethical behavioral traits acceptable among the Yoruba people. Oral interviews couples with recording gadgets were used to collate both sample parents' and children’s responses within a particular community in Owo (ute) local government area of Owo Ondo State, Nigeria. Findings reveal that diverse tales told at moonlight periods have an untold impact on the speedy growth of the children intellectually than the modern happenings around them. These telltale stories become powerful aids in learning goodly traits and eschewing bad manners. It is recommended that folk stories be told within the household among the family after hard labour in the evenings as this would help develop human relationships and brings about a strong sense of community bindings.

Keywords: folktales, folklores, impact, advancement, ethical progression

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Authors: Nga Yui Tong

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Mandarin, the official language of China, is based on the Beijing dialect and is spoken by more than one billion people from all over the world. To investigate the trends of Mandarin acquisition, 192 preschoolers are recruited by stratified random sampling. They are from 4 different districts in Beijing, 2 schools in each district, with 4 age groups, both genders, and 3 children in each stratum. The children are paired up to conduct semi-structured free play for 30 minutes. Their language output is videotaped, transcribed, and coded for the calculation of Mean Length of Utterance (MLU). Two-way ANOVA showed that the variation of MLU is significantly contributed by age, which is coherent to previous findings of other languages. This first large-scale study to investigate the developmental trend of Mandarin in young children in Beijing provides empirical evidence to the development of standards and curriculum planning for early Mandarin education. Interestingly, the gender effect in the study is insignificant, with boys showing a slightly higher MLU than girls across all age groups and settings, except the 4.5 years same-gender dyads. The societal factors in the Chinese context on parenting and gender bias are worth looking into.

Keywords: Beijing, language development, Mandarin, preschoolers

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Authors: Tanvi Rajesh Sanghavi

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Introduction: Neurodiversity is a concept which captures the different ways in which everyone's brain functions and is considered as part of normal variation. It is a strength-based approach which focuses on the individual's strengths and capabilities and believes in providing support wherever necessary. In many parts of the world, those diagnosed with autism spectrum disorder have been ostracized and ridiculed due to their sensory and communication differences. Hence, it becomes important for the teachers to have knowledge about autism and understand the needs of children with Autism. Need: India is rich in terms of culture, languages and religious diversity. It is important to study neurodiversity in such a population for better understanding of neurodiverse individuals and appropriate intervention. Aim & objectives: This study seeks teachers' knowledge of the causes, traits and educational requirements of children with autism spectrum disorder (ASD). It also aims to find out whether mainstream schools actually provide training programs to the teachers to manage such children along with the necessary accommodations. Method: The current study was a cross-sectional study conducted among school teachers. A total of 30 school teachers were taken for the study. The participants were enrolled after informed consent. The participants were directed to a google form consisting of objective questions. The first part of the questionnaire elicited information about school, teaching experience, qualification, etc. There were specific questions extracting details on attending/conducting sensitization and professional programs in regard to care for autistic children. The second part of the questionnaire consisted of some basic questions on the teacher’s understanding of diagnosis, traits, causes, road to recovery and understanding the educational and communication needs of autistic children from the teacher’s perspective. The responses were tabulated and analyzed descriptively. Results: Most of the teachers had 5–10 years of teaching experience. The majority of the teachers used the term “special child” for autistic children. Around 54.8% (17 teachers) of the total teachers felt that the parents of autistic children should teach their child to learn adaptive skills and 41.9% of the teachers felt that they should take medical intervention. About 50% of the teachers felt that the cause of autism is related to pre-natal maternal factors and about 40% felt that its cause is genetic. Only a small percentage of teachers felt that they were trained to manage the children with autism. More than 50% of the teachers mentioned that their schools do not conduct training programs for managing these children. Discussion & Conclusion: In this study, the knowledge and perspectives of teachers on children with ASD were studied. The most widely held contemporary belief is that genetic factors play a major part in the development of ASD, although the existing evidence is muddled, with numerous opposing perspectives on the nature of this mechanism. It is worth noting that any culture's level of humanity is mirrored in how that society "treats" its vulnerable population.

Keywords: autism, neurodiversity, awareness, education

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Authors: Melissa K. Hord, Stephen P. Whiteside

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Impairment in functioning is a requirement for diagnosing psychopathology, identifying individuals in need of treatment, and documenting improvement with treatment. Further, identifying different types of functional impairment can guide educators and treatment providers. However, most assessment tools focus on symptom severity and few measures assess impairment associated with childhood anxiety disorders. The child- and parent-report versions of the Child Sheehan Disability Scale (CSDS) are measures that may provide useful information regarding impairment. The purpose of the present study is to examine whether children diagnosed with different anxiety disorders have greater impairment in school or home functioning based on self or parent report. The sample consisted of 844 children ages 5 to 19 years of age (mean 13.43, 61% female, 90.9% Caucasian), including 281 children diagnosed with obsessive compulsive disorder (OCD), 200 with generalized anxiety disorder (GAD), 176 with social phobia, 83 with separation anxiety, 61 with anxiety not otherwise specified (NOS), 30 with panic disorder, and 13 with panic with agoraphobia. To assess whether children and parents reported greater impairment in school or home functioning, a multivariate analysis of variance was conducted. (The assumptions of independence and homogeneity of variance were checked and met). A significant difference was found, Pillai's trace = .143, F (4, 28) = 4.19, p < .001, partial eta squared = .04. Post hoc comparisons using the Tukey HSD test indicated that children report significantly greater impairment in school with panic disorder (M=5.18, SD=3.28), social phobia (M=4.95, SD=3.20), and OCD (M=4.62, SD=3.32) compared to other diagnoses; whereas parents endorse significantly greater school impairment when their child has a social phobia (M=5.70, SD=3.39) diagnosis. Interestingly, both children and parents reported greater impairment in family functioning for an OCD (child report M=5.37, SD=3.20; parent report M=5.59, SD=3.38) diagnosis compared to other anxiety diagnoses. (Additional findings for the anxiety disorders associated with less impairment will also be presented). The results of the current study have important implications for educators and treatment providers who are working with anxious children. First, understanding that differences exist in how children and parents view impairment related to childhood anxiety can help those working with these families to be more sensitive during interactions. Second, evidence suggests that difficulties in one environment do not necessarily translate to another environment, thus caregivers may benefit from careful explanation of observations obtained by educators. Third, results support the use of the CSDS measure by treatment providers to identify impairment across environments in order to more effectively target interventions.

Keywords: anxiety, childhood, impairment, school functioning

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Authors: Londeka Ngubane

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The use of corporal punishment is not a new phenomenon in the South African education system as it was, for a long time, recognised as a fitting form of punishment for ill-disciplined and disobedient children. The growing recognition that corporal punishment is an act of violence against children has resulted in the abolishment of this form of punishment in society and particularly in schools. However, regardless of criminalising corporal punishment, it appears to be a disciplinary measure that is persistently used by some educators. Historically and currently, the intimate connection between corporal punishment and discipline has not merely been a convention of human thinking, as this practice is given recognition in various definitions in dictionaries. ‘To discipline’ is habitually stated to mean ‘to punish’. The notion of ‘disciplining children’ also comes from entrenched common conceptions about children and their relationship with adults. Corporal punishment has, for a long time, been associated with the rearing and education of children, and this practice thus pervades schooling across nations. In many societies, punishment is a term that is closely linked with the self-perception of teachers who feel that they must be ‘in control’ and have ‘the upper hand’ in order to be respected. This impression of control is evident in the widespread conception of education which is to ‘socialize’ children in ‘desirable ways’ of ‘sitting in a formal classroom’, ‘behaving’ in school, ‘following instructions’ from the teacher, talking only when asked to, and finishing tasks on time. It was against this backdrop that a comprehensive review of relevant literature was undertaken and that individual interviews were conducted with fifty learners from four schools (two junior secondary and two senior secondary schools) in a selected township area in KwaZulu-Natal Province. The main aim of the study was to explore and thus understand learners’ views on the administration of corporal punishment regardless of the fact that it was legally abolished. It was envisaged that the interviews with the learners would elicit rich data that would enhance the researcher’s insight into their perceptions of the persistent use of corporal punishment as a disciplinary measure in their schools. The study was thus premised on the assumption, which had been strengthened by anecdotal and media evidence, that corporal punishment was still administered in some schools in South Africa and in schools in the study area in particular.

Keywords: corporal punishment, ban, school learners, South Africa

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Authors: S. Hussain, C. Grieco, M. Brosnan

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Background and Aims: Autism is a complex neurobehavioural disorder, characterised by impairments in the development of language and communication skills. The study involved a state-of-art systematic review, in addition to qualitative data analysis, to establish the evidence for social stories as an intervention strategy for autistic children. An up-to-date review of the use of digital technologies in the delivery of interventions to autistic children was also carried out; to propose the efficacy of digital technologies and the use of social stories to improve intervention outcomes for autistic children. Methods: Two student researchers reviewed a range of randomised control trials and observational studies. The aim of the review was to establish if there was adequate evidence to justify recommending social stories to autistic patients. Students devised their own search strategies to be used across a range of search engines, including Ovid-Medline, Google Scholar and PubMed. Students then critically appraised the generated literature. Additionally, qualitative data obtained from a comprehensive online questionnaire on social stories was also thematically analysed. The thematic analysis was carried out independently by each researcher, using a ‘bottom-up’ approach, meaning contributors read and analysed responses to questions and devised semantic themes from reading the responses to a given question. The researchers then placed each response into a semantic theme or sub-theme. The students then joined to discuss the merging of their theme headings. The Inter-rater reliability (IRR) was calculated before and after theme headings were merged, giving IRR for pre- and post-discussion. Lastly, the thematic analysis was assessed by a third researcher, who is a professor of psychology and the director for the ‘Centre for Applied Autism Research’ at the University of Bath. Results: A review of the literature, as well as thematic analysis of qualitative data found supporting evidence for social story use. The thematic analysis uncovered some interesting themes from the questionnaire responses, relating to the reasons why social stories were used and the factors influencing their effectiveness in each case. However, overall, the evidence for digital technologies interventions was limited, and the literature could not prove a causal link between better intervention outcomes for autistic children and the use of technologies. However, they did offer valid proposed theories for the suitability of digital technologies for autistic children. Conclusions: Overall, the review concluded that there was adequate evidence to justify advising the use of social stories with autistic children. The role of digital technologies is clearly a fast-emerging field and appears to be a promising method of intervention for autistic children; however, it should not yet be considered an evidence-based approach. The students, using this research, developed ideas on social story interventions which aim to help autistic children.

Keywords: autistic children, digital technologies, intervention, social stories

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Authors: Adi Gielgun-Katz, Alina S. Rusu

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In the last two decades, education systems worldwide have integrated new pedagogical methods and strategies in lesson plans, such as innovative technologies, social-emotional learning (SEL), gamification, mixed learning, multiple literacies, and many others. Visual language, such as photographs, is known to transcend cultures and languages, and it is commonly used by youth to express positions and affective states in social networks. Therefore, visual language needs more educational attention as a linguistic and communicative component that can create connectedness among the students and their teachers. Nowadays, when SEL is gaining more and more space and meaning in the area of academic improvement in relation to social well-being, and taking and sharing pictures is part of the everyday life of the majority of people, it becomes natural to add the visual language to SEL approach as a reinforcement strategy for connecting education to the contemporary culture and language of the youth. This article presents a program conducted in a high school class in Israel, which combines the five SEL with photography techniques, i.e., Social-Emotional Learning Visual Empowerments (SELVEs) program (experimental group). Another class of students from the same institution represents the control group, which is participating in the SEL program without the photography component. The SEL component of the programs addresses skills such as: troubleshooting, uncertainty, personal strengths and collaboration, accepting others, control of impulses, communication, self-perception, and conflict resolution. The aim of the study is to examine the effects of programs on the level of the five SEL aspects in the two groups of high school students: Self-Awareness, Social Awareness, Self-Management, Responsible Decision Making, and Relationship Skills. The study presents a quantitative assessment of the SEL programs’ impact on the students. The main hypothesis is that the students’ questionnaires' analysis will reveal a better understanding and improvement of the five aspects of the SEL in the group of students involved in the photography-enhanced SEL program.

Keywords: social-emotional learning, photography, education program, adolescents

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Authors: Dalila Lino

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The power of play for learning and development in early childhood education is beyond question. The main goal of this study is to analyse how three contemporary early childhood pedagogical approaches, the High Scope, the Modern School Movement (MEM) and the Pedagogy of Participation integrate play in their curriculum development. From this main goal the following objectives emerged: (i) to characterize how play is integrated in the daily routine of the pedagogical approaches under study; (ii) to analyse the teachers’ role during children’s playing situations; (iii) to identify the types of play that children are more often involved. The methodology used is the qualitative approach and is situated under the interpretative paradigm. Data is collected through semi-structured interviews to 30 preschool teachers and through observations of typical daily routines. The participants are 30 Portuguese preschool classrooms attending children from 3 to 6 years and working with the High Scope curriculum (10 classrooms), the MEM (10 classrooms) and the Pedagogy of Participation (10 classrooms). The qualitative method of content analysis was used to analyse the data. To ensure confidentiality, no information is disclosed without participants' consent, and the interviews were transcribed and sent to the participants for a final revision. The results show that there are differences how play is integrated and promoted in the three pedagogical approaches. The teachers’ role when children are at play varies according the pedagogical approach adopted, and also according to the teachers’ understanding about the meaning of play. The study highlights the key role that early childhood curriculum models have to promote opportunities for children to play, and therefore to be involved in meaningful learning.

Keywords: curriculum models, early childhood education, pedagogy, play

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Authors: Bassma A. Abdelhaleem, Mamdouh A. Abdulrhman, Nagwa I. Mohamed

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Malnutrition in children is an increasing problem worldwide which may result in both short and long-term irreversible negative health outcomes. Severe Acute Malnutrition (SAM) affects more than 18 million children each year, mostly living in low-income settings. SAM contributes to 45% of all deaths in children less than five years of age. Honey is a natural sweetener, containing mainly monosaccharides (up to 80%), disaccharides (3–5%), water (17–20%), and a wide range of minor constituents such as vitamins, minerals, proteins, amino acids, enzymes, and phytochemicals, mainly phenolic acids, and flavonoids. Honey has been used in many cultures around the world due to its known nutritional and medicinal benefits including the treatment of hypercholesterolemia. Despite its use since ancient times yet little is known about its potential benefits for malnourished children. Honey has the potential to be an affordable solution for malnourished low-income children as it is nutrient-dense and calorie dense food, easily absorbed, highly palatable, enhances appetite, and boosts immunity. This study assessed the effect of clover honey supplementation on the anthropometric measurements and lipid profile of malnourished infants and children. A prospective interventional clinical trial was conducted between November 2019 to November 2020, on 40 malnourished infants and children divided into two groups: Group A (20 children; 11 males and 9 females) received honey in a dose of 1.75ml/kg/dose, twice weekly for 12 weeks and Group B (20 children; 6 males and 14 females) received placebo. Written informed consent was obtained for parents/guardians. Patients were recruited from the Pediatric Nutrition Clinic at Ain Shams University. Anthropometric measurements (weight, height, body mass index, head circumference, and mid-arm circumference) and fasting serum cholesterol levels were measured at baseline and after 3 months. The 3-month honey consumption had a statistically highly significant effect on increasing weight, height, and body mass index and lowering fasting serum cholesterol levels in primary malnourished infants and children. Weight, height, body mass index, and fasting serum cholesterol level before honey consumption were (9.49 ± 2.03, 81.45 ± 8.31, 14.24 ± 2.15, 178.00 ± 20.91) and after 3 months of honey consumption were (10.91 ± 2.11, 84.80 ± 8.23, 15.07 ± 2.05, 162.45 ± 19.73) respectively with P-value < 0.01. Our results showed a significant desirable effect of honey consumption on changes in nutritional status based on weight, height, and body mass index, and has a favourable effect on lowering fasting serum cholesterol levels. These results propose the use of honey as an affordable solution to improve malnutrition, particularly in low-income countries. However, further research needs to weigh benefits against potential harms including the risk of botulinum toxin that is historically associated with honey consumption in early childhood.

Keywords: clinical trial, dyslipidemia, honey, malnutrition

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Authors: Myriam Castonguay, Florence Vinit

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This study aims to gain a better understanding of the lived experience of seven children growing up in a family where another child is severely disabled, informed by family systems theory and the socio-ecological model of development. In depth semi-structured interviews were conducted with seven children who described they everyday life since their brother’s or sister’s diagnosis. Thematic analysis revealed four themes : struggling with loneliness inside the family, supporting the disabled child through its journey, accommodating to a changing routine and keeping a “bubble” for oneself. Brothers and sisters depict a family life characterized by much loneliness, with severe disabilities requiring ongoing care and prolonged hospitalizations. In the midst of adversity, siblings describe themselves as highly committed to supporting the disabled child and to preserve family cohesion, even if that means getting exposed to emotionally challenging situations and adjusting their daily routine frequently. Children recount that keeping up with schoolwork and leisure activities of their own is central to their well-being. Having a space where one can reconnect with his ordinary life as a kid is also deemed very important. This study reminds us that more needs to be done to counteract the loneliness experienced by siblings through the family experience of disability. Family members and clinicians need to be extra vigilant to ensure siblings’ needs don’t go unnoticed or dismissed, as it may be difficult for this population of children to voice their own experience and needs. Family, school and other actors in the community may help brothers and sisters pursue their personal dreams, goals and projects, to continue experiencing well-being despite adverse life circumstances.

Keywords: sibling’s lived experience of disability, sibling’s needs at various levels of the ecosystem, family adjustment to the disability experience, supporting family wellness through the disability experience

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Renate Gericke, Carol Long

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Despite the robust empirical support of attachment, advancement in the description and conceptualization of attachment has been slow and has not significantly advanced beyond the identification of attachment security or type (namely, secure, avoidant, ambivalent and disorganized). This has continued despite papers arguing for theoretical refinement in the classification of attachment presentations. For thinking and practice to advance, it is critically important that these categories and their assessment be interrogated in different contexts and across developmental age. To achieve this, a quantitative design was used with descriptive and inferential statistics, and general linear models were employed to analyze the data. The Attachment Story Completion Test (ASCT) was administered to 105 children between the ages of eight and twelve from socio-economically deprived contexts with high exposure to trauma. A staggering 93% of the children had insecure attachments (specifically, avoidant 37%, disorganized 34% and ambivalent 22%) and attachment was more complex than currently conceptualized in the attachment literature. Primary attachment did not only present as one of four discreet categories, but 70% of the sample had a complex attachment with more than one type of maternal attachment style. Attachment intensity also varied along a continuum (between 1 and 5). The findings have implications for a) research that has not considered the potential complexity of attachment or attachment intensity, b) policy to more actively support mother-infant dyads, particularly in high-risk contexts and c) question the applicability of a western conceptualization of a primary maternal attachment figure in non-western collectivist societies.

Keywords: attachment, children at risk, middle childhood, non-western context

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