Search results for: children act 2022 kenya

Authors: Alexander Musyoki, Collins Odour

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Over the past few years, the bakery industry in Kenya has experienced significant growth largely in part to the increased adoption of technology and automation in their processes; more specifically due to the adoption of bakery management systems to help in running bakeries. While they have been largely responsible for the improved productivity and efficiency in bakeries, most of them are now outdated and pose more challenges than benefits. The proposed online bakery management system mentioned in this paper aims to address this by allowing bakery owners to track inventory, budget, job progress, and data analytics on each job and in doing so, promote the Sustainable Development Goals 3 and 12, which aim to ensure healthy lives and promote sustainable economic growth as the proposed benefits of these features include scalability, easy accessibility, reduced acquisition costs, better reliability, and improved functionality that will allow bakeries to become more competitive, reduce waste and track inventory more efficiently. To better understand the challenges, a comprehensive study has been performed to assess these traditional systems and try to understand if an online bakery management system can prove to be advantageous to bakery owners. The study conducted gathered feedback from bakery owners and employees in Nairobi County, Kenya using an online survey with a response rate of about 86% from the target population. The responses cited complex and hard to use bakery management systems (59.7%), lack of portability from one device to the other (58.1%) and high acquisition costs (51.6%) as the top challenges of traditional bakery management systems. On the other hand, some of the top benefits that most of the respondents would realize from the online bakery management system was better reliability (58.1%) and reduced acquisition costs (58.1%). Overall, the findings suggest that an online bakery management system has a lot of advantages over traditional systems and is likely to be well-received in the market. In conclusion, the proposed online bakery management system has the potential to improve the efficiency and competitiveness of small-sized bakeries in Nairobi County. Further research is recommended to expand the sample size and diversity of respondents and to conduct more in-depth analyses of the data collected.

Keywords: ICT, technology and automation, bakery management systems, food innovation

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Authors: Susan Thurstans, Natalie Sessions, Carmel Dolan, Kate Sadler, Bernardette Cichon, Shelia Isanaka, Dominique Roberfroid, Heather Stobagh, Patrick Webb, Tanya Khara

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For many years, wasting and stunting have been viewed as separate conditions without clear evidence supporting this distinction. In 2014, the Emergency Nutrition Network (ENN) examined the relationship between wasting and stunting and published a report highlighting the evidence for linkages between the two forms of undernutrition. This systematic review aimed to update the evidence generated since this 2014 report to better understand the implications for improving child nutrition, health and survival. Following PRISMA guidelines, this review was conducted using search terms to describe the relationship between wasting and stunting. Studies related to children under five from low- and middle-income countries that assessed both ponderal growth/wasting and linear growth/stunting, as well as the association between the two, were included. Risk of bias was assessed in all included studies using SIGN checklists. 45 studies met the inclusion criteria- 39 peer reviewed studies, 1 manual chapter, 3 pre-print publications and 2 published reports. The review found that there is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Possible interconnected physiological processes and common risk factors drive an accumulation of vulnerabilities. Peak incidence of both wasting and stunting was found to be between birth and three months. A significant proportion of children experience concurrent wasting and stunting- Country level data suggests that up to 8% of children under 5 may be both wasted and stunted at the same time, global estimates translate to around 16 million children. Children with concurrent wasting and stunting have an elevated risk of mortality when compared to children with one deficit alone. These children should therefore be considered a high-risk group in the targeting of treatment. Wasting, stunting and concurrent wasting and stunting appear to be more prevalent in boys than girls and it appears that concurrent wasting and stunting peaks between 12- 30 months of age with younger children being the most affected. Seasonal patterns in prevalence of both wasting and stunting are seen in longitudinal and cross sectional data and in particular season of birth has been shown to have an impact on a child’s subsequent experience of wasting and stunting. Evidence suggests that the use of mid-upper-arm circumference combined with weight-for-age Z-score might effectively identify children most at risk of near-term mortality, including those concurrently wasted and stunted. Wasting and stunting frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence suggests there is a process of accumulation of nutritional deficits and therefore risk over the life course of a child demonstrates the need for a more integrated approach to prevention and treatment strategies to interrupt this process. To achieve this, undernutrition policies, programmes, financing and research must become more unified.

Keywords: Concurrent wasting and stunting, Review, Risk factors, Undernutrition

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Authors: Sabina Garayeva

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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.

Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR

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Authors: Debangana Mukherjee

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This study delves into the pivotal role of parenting styles in shaping the development of aggression and empathy in children aged 10 to 12. Using a sample of 300 school students, we employed self-assessment questionnaires and scales to investigate correlations between parenting styles—authoritative, authoritarian, permissive, and neglectful—and behavioural traits, focusing on aggression and empathy as primary outcomes. The findings underscore the intricate relationships between parenting styles, aggressive behaviours, and empathetic tendencies. Notably, certain parenting approaches demonstrated strong correlations with specific behavioural outcomes. For instance, authoritarian parenting showed associations with increased aggression and reduced empathy, while authoritative parenting exhibited the opposite trend. These correlations emphasize the potential impact of parenting styles on children's behavioural development during this critical transitional phase. However, this study is limited by its correlational nature, which does not imply causation. The complexities of human behaviour, the limited scope of analysis, and the need for further research into causative relationships and cultural influences call for a nuanced understanding of these dynamics. Moving forward, longitudinal studies, causality investigations, consideration of cultural diversity, and exploration of additional variables could enrich our understanding of the interplay between parenting styles, empathy, and aggression. Validating these findings across diverse populations and refining interventions could pave the way for nurturing healthy behavioural development in children.

Keywords: aggression, correlational nature, empathy, longitudinal studies, parenting style

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Authors: Li Shuping, Shu Huaping, Yi Chaofan, Tao Jiang

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Equestrian practice is often considered having a unique effect on improving symptoms in children with autism. This study evaluated and measured the changes in daily behavior, morphological, physical function, and fitness indexes of two group children with autism by means of 12 weeks of equestrian and basketball exercises. 19 clinically diagnosed children with moderate/mild autism were randomly divided into equestrian group (9 children, age=10.11±1.90y) and basketball group (10 children, age=10.70±2.16y). Both the equestrian and basketball groups practiced twice a week for 45 to 60 minutes each time. Three scales, the Autism Behavior Checklist (ABC), the Childhood Autism Rating Scale (CARS) and the Clancy Autism Behavior Scale (CABS) were used to assess their human behavior and psychology. Four morphological, seven physical function and fitness indicators were measured to evaluate the effects of the two exercises on the children’s body. The evaluations were taken by every four weeks ( pre-exercise, the 4th week, the 8th week and 12th week (post exercise). The result showed that the total scores of ABC, CARS and CABS, the dimension scores of ABC on the somatic motor, language and life self-care obtained after exercise were significantly lower than those obtained before 12 week exercises in both groups. The ABC feeling dimension scores of equestrian group and ABC communication dimension score of basketball group were significantly lower,and The upper arm circumference, sitting forward flexion, 40 second sit-up, 15s lateral jump, vital capacity, and single foot standing of both groups were significantly higher than that of before exercise.. The BMI of equestrian group was significantly reduced. The handgrip strength of basketball group was significantly increased. In conclusion, both types of exercises could improve daily behavior, morphological, physical function, and fitness indexes of the children with autism. However, the behavioral psychological scores, body morphology and function indicators and time points were different in the middle and back of the two interventions.But the indicators and the timing of the improvement were different. To the group of equestrian, the improvement of the flexibility occurred at week 4, the improvement of the sensory perception, control and use their own body, and promote the development of core strength endurance, coordination and cardiopulmonary function occurred at week 8，and the improvement of core strength endurance, coordination and cardiopulmonary function occurred at week 12. To the group of basketball, the improvement of the hand strength, balance, flexibility and cardiopulmonary function occurred at week 4, the improvement of the self-care ability and language expression ability, and core strength endurance and coordination occurred at week 8, the improvement of the control and use of their own body and social interaction ability occurred at week 12. In comparison of the exercise effects, the equestrian exercise improved the physical control and application ability appeared earlier than that of basketball group. Basketball exercise improved the language expression ability, self-care ability, balance ability and cardiopulmonary function of autistic children appeared earlier than that of equestrian group.

Keywords: intervention, children with autism, equestrain, basketball

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Authors: Njoroge Margaret W., Johnson Deborah

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Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.

Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD

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Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore

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Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.

Keywords: dental caries, life course, Bahrain, school outcomes

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Authors: Justin Lee, Siraj Shaikh, Alice Chu MD

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Children with cerebral palsy (CP) commonly present with upper extremity impairment, affecting one or both extremities, and are classified using the Manual Ability Classification Scale (MACS). The MACS defines bimanual hand abilities for children ages 4-18 years in everyday tasks and is a gradient scale, with I being nearly normal and V requiring total assistance. Children with more severe upper extremity impairment (MACS III-V) are often underrepresented, and relatively few effective therapies have been identified for these patients. Current orthoses are static and are only meant to prevent the progression of contractures in these patients. Other limitations include cost, comfort, accessibility, and longevity of the orthoses. Taking advantage of advances in 3D printing technology, we have created a highly customizable upper extremity orthotic that can be produced at a low cost. Iterations in our design have resulted in an orthotic that is custom fit to the patient based on scans of their arm, made of rigid polymer when needed to provide support, flexible material where appropriate to allow for comfort, and designed with a mechanical pulley system to allow for some functional use of the arm while in the orthotic. Preliminary data has shown that our orthotic can be built at a fraction of the cost of current orthoses and provide clinically significant improvement in assisting hand assessment (AHA) and pediatric quality of life scores (PedsQL).

Keywords: upper extremity orthosis, upper extremity, orthosis, 3-D printing, cerebral palsy, occupational therapy, spasticity, customizable

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Authors: Shan Jiang

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Child aggression represents a significant global issue, with its familial determinants being crucial. Family is a vital context for child development, but prior research on the impact of parental assortative mating on child aggression is limited. This study investigates the effects of assortative mating on child aggression, elucidating the mediating mechanisms involved and examining gender-specific responses, within a substantial sample of 10,570 parents and their children, grades 1-6, in Hangzhou City, Zhejiang Province, China. The findings indicate that children exhibit a significant increase in aggressive behaviors when maternal income surpasses paternal income, contrasted with families where the father's income is higher. The study identifies family communication, co-parenting quality, and parental problem-solving strategies as significant mediators in the relationship between parental income/education differences and child aggression. This research contributes to understanding the parental influence on child behavior within the family system and offers valuable implications for child protection policy and intervention strategies.

Keywords: assortative mating, aggression, children, family

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Authors: Ya-Hsing Yeh, I-Chun Tai, Ming-Chieh Lin, Li-Ting Lee, Ping-Ting Hsieh, Yi-Chen Ling, Jhia-Ying Du, Li-Ping Chang, Guan-Long Yu

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Objective: To understand the connection between children/adolescents and those who they miss, as well as the correlation between connection and their emotions. Method: Based on the objective, a close-ended questionnaire was made into a formal questionnaire after experts evaluated its validity. In February 2017, the paper-based questionnaire was adopted. Twenty-one elementary schools and junior high schools in Taiwan were sampled by purposive sampling approach and the fifth to ninth graders were our participants. A total of 2,502 valid questionnaires were retrieved. Results: Forty-four-point three percent of children/adolescents missed a person in mind, or they thought a person as a significant other in mind, but they had no connection with them. The highest proportion of those they wanted to contact with was ‘Friends and classmates’, and the others were ‘immediate family’, such as parents and grandparents, and ‘academic or vocational instructors, such as home-room teachers, coaches, cram school teachers and so on, respectively. Only 14% of children/adolescents would actively contact those they missed. The proportion of what children/adolescents ‘often’ actively keeping in touch with those they missed felt happy or cheerful was higher compared with those who ‘seldom’ actively keeping in touch with people they missed whenever they recalled who they missed, or the person actively contacted with them. Sixty-one-point seven percent of participants haven’t connected with those they missed for more than one year. The main reason was ‘environmental factors’, such as school/class transfer or moving, and then ‘academic or personal factors’, ‘communication tools’, and ‘personalities’, respectively. In addition to ‘greetings during festivals and holidays’, ‘hearing from those they missed’, and ‘knowing the latest information about those they missed on their Internet communities’, children/adolescents would like to actively contact with them when they felt ‘happy’ and ‘depressed or frustrated. The first three opinions of what children/adolescents regarded truly connection were ‘listening to people they missed attentively’, ‘sharing their secrets’, and ‘contacting with people they regularly missed with real actions’. In terms of gender, girls’ proportion on ‘showing with actions, including contacting with people they missed regularly or expressing their feelings openly’, and ‘sharing secrets’ was higher than boys’, while boy’s proportion on ‘the attitudes when contacting people they missed, including listening attentively or without being distracted’ was higher than girls’. Conclusions: I. The more ‘active’ connection they have, the more happiness they feel. II. Teachers can teach children how to manage their emotions and express their feelings appropriately. III. It is very important to turn connection into ‘action.’ Teachers can set a good example and share their moods with others whatever they are in the mood. This is a kind of connection.

Keywords: children, connection, emotion, mental health

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Authors: Eudjen Cinc

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Work with a human voice, especially with a child s voice and cultivating the sound of the choir, presents an area of crucial importance for a conductor. We use the term conductor because it needs to be understood that regardless of whether we have in front of us an amateur or a professional choir, whether they are singers with a wealth of experience or children who are still developing and educating their inner ear so that in the future they could contribute to the development of choir music, the person who stands in front of the group and works with them, needs to have the characteristics of a conductor. Voice formation is a long-term process, without which there is no success in both solo and collective music performance.

Keywords: music group, conductor, collective, performance

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Authors: Lynn Mcquarrie, Charlotte Enns

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The goal of this project was to develop a visually-based, signed language phonological awareness training program and to pilot the intervention with signing deaf children (ages 6 -10 years/ grades 1 - 4) who were beginning readers to assess the effects of systematic explicit American Sign Language (ASL) phonological instruction on both ASL vocabulary and English print vocabulary learning. Growing evidence that signing learners utilize visually-based signed language phonological knowledge (homologous to the sound-based phonological level of spoken language processing) when reading underscore the critical need for further research on the innovation of reading instructional practices for visual language learners. Multiple single-case studies using a multiple probe design across content (i.e., sign and print targets incorporating specific ASL phonological parameters – handshapes) was implemented to examine if a functional relationship existed between instruction and acquisition of these skills. The results indicated that for all cases, representing a variety of language abilities, the visually-based phonological teaching approach was exceptionally powerful in helping children to build their sign and print vocabularies. Although intervention/teaching studies have been essential in testing hypotheses about spoken language phonological processes supporting non-deaf children’s reading development, there are no parallel intervention/teaching studies exploring hypotheses about signed language phonological processes in supporting deaf children’s reading development. This study begins to provide the needed evidence to pursue innovative teaching strategies that incorporate the strengths of visual learners.

Keywords: American sign language phonological awareness, dual language strategies, vocabulary learning, word reading

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Authors: Mary Holstein

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Objective: The aim of this study was to evaluate nurse leader confidence in emergency management and disaster preparedness in the state of Texas. My project was a replication study of a survey conducted in 2022 by Reedy et al, for members of the Northwest Organization for Nurse Leaders (NONL). Background: In 2022, the American Association of Colleges of Nursing (AACN) approved new essentials for academic nursing education programs to demonstrate competencies in disaster management, yet no integration of such information into nursing curriculum had been reported in the literature. Research replicated by members of the Texas Organization for Nursing Leadership suggested significant gaps in nurse leader confidence across roles and in structured education that prepares nurse leaders across the spectrum of experience to lead in a crisis. Methods: An exploratory, cross-sectional survey used a sample of 86 RNs who were members of TONL. Results: Results replicated comparable results with significant variance in nurse leader confidence across roles, experience, and previous disaster-related education. Positive associations regarding nurse leaders' confidence in managing disasters were obvious with more advanced positions, further education, and mandatory training. Conclusions: Nursing leaders in Texas lack mandatory and structured education to prepare for emergency and disaster management. The call for mandatory emergency management training and disaster preparedness for nurse leaders remains unmet.

Keywords: confidence, disaster, education, emergency

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Authors: Rashmi Tyagi, Savita Vermani

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Violence against women is the result of long-standing power imbalance between men and women and thus seriously compromises the well-being, productivity and contribution of one half the population. The costs incurred to the family especially children and society at large in terms of physical, psychological, social and financial losses are huge. The communities’ native to the state of Haryana in India is primarily patriarchal, burdened with age old regressive mindset under the socio-cultural and religious structures which discriminates against women. Therefore it was important to bring to light the issues affecting women in this region. Therefore this study focused on studying the consequences of crime on victim women and their families. Two hundred women were randomly selected and out of those one hundred twenty, who were affected with some kind of violence were interviewed. Data was collected and statistically analyzed for physical, psychological, inter-family and societal consequences of violence on these women. Women reported physical injuries, gynecological problems, unwanted pregnancies, frigidity, phobia and sexual dysfunction. 58.9% women felt decreased work efficiency. Psychological problems encountered were anxiety, isolation, depression, suicidal tendencies. 66.7% respondents suffered from anxiety followed by 65.0% faced depression symptoms. At family levels, 40.0% respondents felt the atmosphere was unsuitable for children while 39.2% reported lack of interaction. The societal consequences reported were breakdown of interaction with friends and family (44.2%) and resulting humiliation and demeaning remarks from others (38.3%). The impact of violence on women had an adverse effect on children. 36.7% children felt responsible for abuse and powerless to stop it, 29.2% reported living with fear. Concerted efforts are required to curb violence against women in Haryana.

Keywords: impact of violence against women on children, patriarchal society, physical psychological and societal consequences, violence against women

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Authors: M. Shukry

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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention, particularly in the pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. Twenty-eight, 29, 34, and 34 children were involved in Group 1 (healthy), 2 (obese), 3 (morbid obese), and 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the participants. The classification of obese groups was performed based upon the recommendations of the World Health Organization. Metabolic syndrome components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by a body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference, and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index, and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, the group, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: children, fat mass, fat-free mass, macrominerals, obesity

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Authors: Benyam Zenebe, Tesfaye Sisay, Gurja Belay, Workabeba Abebe

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Background: The prevalence and antibiogram of pathogenic E. coli strains, which cause diarrhea vary from region to region, and even within countries in the same geographical area. In Ethiopia, diagnostic approaches to E. coli induced diarrhea in children less than five years of age are not standardized. The aim of this study was to determine the involvement of pathogenic E. coli strains in child diarrhea and determine the antibiograms of the isolates in children less than 5 years of age with diarrhea at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A purposive study that included 98 diarrheic children less than five years of age was conducted at Addis Ababa University College of Health Sciences, TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia to detect pathogenic E. coli biotypes. Stool culture was used to identify presumptive E. coliisolates. Presumptive isolates were confirmed by biochemical tests, and antimicrobial susceptibility tests were performed on confirmed E. coli isolates by the disk diffusion method. DNA was extracted from confirmed isolates by a heating method and subjected to Polymerase Chain Reaction or the presence of virulence genes. Amplified PCR products were analyzed by agarose gel electrophoresis. Data were collected on child demographics and clinical conditions using administered questionnaires. The prevalence of E. coli strains from the total diarrheic children, and the prevalence of pathogenic strains from total E. coli isolates along with their susceptibility profiles; the distribution of pathogenic E.coli biotypes among different age groups and between the sexes were determined by using descriptive statistics. Result: Out of 98 stool specimens collected from diarrheic children less than 5 years of age, 75 presumptive E. coli isolates were identified by culture; further confirmation by biochemical tests showed that only 56 of the isolates were E. coli; 29 of the isolates were found in male children and 27 of them in female children. Out of the 58 isolates of E. coli, 25 pathotypes belonging to different classes of pathogenic strains: STEC, EPEC, EHEC, EAEC were detected by using the PCR technique. Pathogenic E. coli exhibited high rates of antibiotic resistance to many of the antibiotics tested. Moreover, they exhibited multiple drug resistance. Conclusion: This study found that the isolation rate of E. coli and the involvement of antibiotic-resistant pathogenic E. coli in diarrheic children is prominent, and hence focus should be given on the diagnosis and antimicrobial sensitivity testing of pathogenic E. coli at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital. Among antibiotics tested, Cefotitan could be a drug of choice to treat E. coli.

Keywords: antibiotic susceptibility profile, children, diarrhea, E. coli, pathogenic

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Authors: Nam-Phuong T. Hoang, Divna Haslam, Matthew Sanders

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Parenting psychological control (PPC) is a parenting manner of which intrusive tactics such as guilt induction, shaming or love withdrawal is adopted to manipulate the child's behavior, emotion and beliefs. PPC has been widely reported to be associated with both psychological dysfunction and low self-esteem in adolescents. Highly demanding and restrictive parenting was also found to related to high rate of risk behaviors, depression, anxiety and anti-social behaviors in adults who co-live with their parents. In many cultures like that of Asia, adults keep on co-live with their parents even after having their own families, and this is not an uncommon practice. Due to the culture obligation of family relationship and the filial piety, children are expected to stay with their parents to taking care of them when they get older, and the parents are also expected to co-live with their children in order to support them with grandchild care. As one become a grandparent, however, it does not means one stop being the parent to their own child. The effect of PPC if exist thus might continue to interfere one’s relationship with their adult children and also their adult child’s parenting. This study was designed to examine that effect of PPC on adults’ life as parents. Data was collected from 501 Vietnamese parents whose children between the age of 2 to 12 and having their parent living with them or taking care of the grandchild on daily basic. Findings show that grandparent psychological control (GPPC) is significantly associated with parent’s harsh parenting, parent’s well-being, and parent-grandparent coparenting relationship. Significantly, GPPC is the strongest predictor for the coparenting conflict between parent and grandparent.

Keywords: parenting psychological control, grandparent, coparenting, well-being

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Authors: Edna Ariste, Richard Standy Coqmar

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Background: Acute respiratory infections are a major public health problem in the world, mainly in vulnerable populations such as newborns, children under five years of age, and the elderly. The objective of this study was to Characterize the cases of acute respiratory infections in infants and under 15 years old hospitalized at the Immaculée Conception Hospital in Cayes from January 1, 2019, to December 31, 2021. Methods: A retrospective descriptive study was conducted on the epidemiology profile of acute respiratory infections hospitalized in the pediatric ward at Immaculée Conception Hospital in Les Cayes from January 2019 to December 2021. The study population consisted of all newborns, infants, and children under 15 years of age diagnosed with respiratory infections at the pediatric service. Data were collected from the hospitalization registers and patient records of this unit. A database was created and used for data collection. Excel and Epi info 7.2 were used for data analysis. Results: A total of 588 cases were identified during the 2019-2021 year. 43.5% (256) were female, and 56.5% (332) were male. The average age was 4, 3. The most affected age group was 1-4 years. The male/female sex ratio was 1.2. The most frequent respiratory infections were respectively pneumonia 44.9%, bronchitis 16.5%, and respiratory distress 10.5%. The mortality rate recorded during this period was 4.4%. Conclusion: Acute respiratory infections are more frequent in young children. It is, therefore, necessary to practice hand hygiene. Reinforce the surveillance of severe acute respiratory infections.

Keywords: acute respiratory infections, pediatrics, cayes, haiti

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Authors: Siti Aisyah

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This article discusses character education which is a very basic education for early childhood with the aim of instilling moral values to prevent unacceptable behaviours. Children can absorb good character when they are in a supportive environment, for that schools should understand and implement character education in the learning process. In the school environment, good character education and habituation can be developed. All parties in the school should be involved, especially the teachers. This research discusses how teachers apply characters on the values of responsibility, honesty, discipline, love and compassion, caring, courage, independence, hard work, mutual cooperation, courtesy, justice, self-control and tolerance. The respondents of this study were teachers involving 200 children from all over Indonesia. The methodology used was a survey method with the result that more than 80% of teachers have been able to exhibit the expected behaviours. The survey was conducted based on observations, types of tasks and assessed performance. The character values can be optimally taught in the school environment based on the teacher's ability to implement them. Through the character education in schools, children can also instil a positive outlook on life.

Keywords: teachers, character strengthening, early childhood, behavior

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Authors: Nickolas A. Stewart, Donald C. Hefelfinger, Garrett V. Brittain, Timothy C. Frommeyer, Adrienne Stolfi

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Orthopedic surgery is currently considered one of the most competitive specialties that medical students can apply to for residency training. As evidenced by increasing United States Medical Licensing Examination (USMLE) scores, overall grades, and publication, presentation, and abstract numbers, this specialty is getting increasingly competitive. The recent change of USMLE Step 1 scores to pass/fail has resulted in additional challenges for medical students planning to apply for orthopedic residency. Until now, these scores have been a tool used by residency programs to screen applicants as an initial factor to determine the strength of their application. With USMLE STEP 1 converting to a pass/fail grading criterion, the question remains as to what will take its place on the ERAS application. The primary objective of this study is to determine the trends in the number of research projects, abstracts, presentations, and publications among orthopedic residency applicants. Secondly, this study seeks to determine if there is a relationship between the number of research projects, abstracts, presentations, and publications, and match rates. The researchers utilized the National Resident Matching Program's Charting Outcomes in the Match between 2007 and 2022 to identify mean publications and research project numbers by allopathic and osteopathic US orthopedic surgery senior applicants. A paired t test was performed between the mean number of publications and research projects by matched and unmatched applicants. Additionally, simple linear regressions within matched and unmatched applicants were used to determine the association between year and number of abstracts, presentations, and publications, and a number of research projects. For determining whether the increase in the number of abstracts, presentations, and publications, and a number of research projects is significantly different between matched and unmatched applicants, an analysis of covariance is used with an interaction term added to the model, which represents the test for the difference between the slopes of each group. The data shows that from 2007 to 2022, the average number of research publications increased from 3 to 16.5 for matched orthopedic surgery applicants. The paired t-test had a significant p-value of 0.006 for the number of research publications between matched and unmatched applicants. In conclusion, the average number of publications for orthopedic surgery applicants has significantly increased for matched and unmatched applicants from 2007 to 2022. Moreover, this increase has accelerated in recent years, as evidenced by an increase of only 1.5 publications from 2007 to 2001 versus 5.0 publications from 2018 to 2022. The number of abstracts, presentations, and publications is a significant factor regarding an applicant's likelihood to successfully match into an orthopedic residency program. With USMLE Step 1 being converted to pass/fail, the researchers expect students and program directors will place increased importance on additional factors that can help them stand out. This study demonstrates that research will be a primary component in stratifying future orthopedic surgery applicants. In addition, this suggests the average number of research publications will continue to accelerate. Further study is required to determine whether this growth is sustainable.

Keywords: publications, orthopedic surgery, research, residency applications

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Authors: Ghazal Zahed, Leila Tabatabaee, Amirhossein Hosseini, Somaye Fatahi

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Functional retentive overflow incontinence (Retentive FI) is the most common cause of fecal soiling in children. Affected patients may have more problems with their parents and peer group, self-esteem issues, and more psychiatric comorbidities than the general population. Therapeutic interventions for Retentive FI and related problems and comorbid conditions are needed at the same time. Based on the clinical experiences, patients with retentive FI and comorbid psychiatric disorders, were accelerated in their treatment of fecal incontinence when they were being treated with Risperidone for their psychiatric comorbidities, therefore this study was conducted to evaluate the effect of Risperidone in the treatment of Retentive FI in children and adolescents. In this double-blind randomized clinical trial, 136 patients aged 4-18 years eligible for the study were randomly divided into two groups receiving Risperidone and placebo. About half of these patients had newly diagnosed psychiatric disorders and were drug naïve, this was considered in their division. In addition to polyethylene glycol, all the participants received family counseling and education for withholding behaviors and related behavioral interventions, and nonpharmacological interventions for psychiatric comorbidities. A significant correlation was observed between the duration of treatment with risperidone and the presence of psychiatric comorbidities (P <0.001) for diurnal fecal incontinence. Based on our findings in this study, Risperidone, used commonly for psychiatric disorders in children and adolescents, may be useful in the treatment of retentive fecal incontinence in the presence of psychiatric comorbidities, and along with other interventions.

Keywords: Retentive Fecal Incontinence, Risperidone, Treatment, Pediatric, Encopresis, Atypical Antipsychotics, Fecal Soiling

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Authors: Marios Loucas, Rafael Loucas, Oliver Muensterer

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Aim of the Study: Over the last two years, there has been a substantial rise of refugees entering Germany, of which approximately one-third are underage. Little is known about the general state of health such as nutrition, dental status and post-traumatic stress disorder among underage refugees. Our study assesses the general health status of underage refugees based on a large sample cohort. Methods: After ethics board approval, we used a structured questionnaire to collect demographic information and health-related elements in 3 large refugee accommodation centers, focusing on nutritional and dental status, as well as symptoms of posttraumatic stress disorder. Main results: A total of 461 minor refugees were included. The majority were boys (54.5%), average age was 8 years. Out of the 8 recorded countries of origin, most children came from Syria (33.6%), followed by Afghanistan (23.2%). Of the participants, 50.3% reported DSM-5 criteria of Posttraumatic stress disorder and presented mental health-related problems. The most frequently reported mental abnormalities were concentration disturbances (15.2%), sleep disorders (6.9%), unclear headaches (5.4%). The majority of the participants showed an unfavorable nutritional and dental status. According to the family, the majority of the children rarely eat healthy foods such as fruits, vegetables and fish. However, the majority of these children (over 90%) consume a large quantity of sugary foods and sweetened drinks such as soft drinks and confectionery at least daily. Caries was found in 63% of the minor children included in the study. A large proportion (47%) reported never brushing their teeth. According to the family, 78.3% of refugee children have never been evaluated by a dentist in Germany. The remainder visited a dentist mainly because of unbearable toothache. Conclusions: Minor refugees have specific psychological, nutritional and dental problems that must be considered in order to ensure appropriate medical care. Posttraumatic stress disorder is mainly caused by physical and emotional trauma suffered either during the flight or in the refugee camp in Germany. These data call for widespread screening of psychological, dental and nutritional problems in underage refugees. Dental care of this cohort is completely inadequate. Nutritional programs should focus on educating the families and providing the means to obtain healthy foods for these children.

Keywords: children, nutrition, posttraumatic stress disorder, refugee

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Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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Authors: Jehnyne Lalaine Bautista, Marquise Baldemor, Ciara Mendoza

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This study is an attempt to investigate the extent to which pre-teens engage in social media, the effects of social media use on the different facets of their identity development such as physical, social, cognitive, aspirations, and personality, as well as the effects of parental regulation on their identity formation. Twelve Filipino children, ages from 9-12 years old and are either regulated, semi-regulated, or unregulated on social media use, participated in this study along with their parent or guardian. The data were gathered through in-depth interviews with the participants and were analyzed through the use of thematic analysis. Results show that despite accessing similar social media applications, the effects of these on children from different types of parental regulation vary since they have different levels of exposure to social media content. Those who have parents with high parental regulation on the use of social media tend to perform better in school, to find time for extracurricular activities, and to develop positive identity formation. The results of this study suggest that parental regulation on social media use has the positive influence on the identity development of children while there are dangers to unregulated use of social media.

Keywords: identity formation, parental regulation, pre-teens, social media

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Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Ayelet Gur

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Background: In recent years we are witnessing a welcome trend in which more children/persons with disabilities are living at home with their families and within their communities. This trend is related to various policy innovations as the UN Convention on the Rights of People with Disabilities that reflect a shift from the medical-institutional model to a human rights approach. We also witness the emergence of family centered approaches that perceive the family and not just the individual with the disability as a worthy target of policy planning, implementation and evaluation efforts. The current investigation aims to explore economic, psychological and social factors among households of families of children or adults with intellectual disabilities in Israel and to present policy recommendation. Methods: A national sample of 301 households was recruited through the education and employment settings of persons with intellectual disability. The main caregiver of the person with the disability (a parent) was interviewed. Measurements included the income and expense surveys; assets and debts questionnaire; the questionnaire on resources and stress; the social involvement questionnaire and Personal Wellbeing Index. Results: Findings indicate significant gaps in financial circumstances between households of families of children with intellectual disabilities and households of the general Israeli society. Households of families of children with intellectual disabilities report lower income and higher expenditures and loans than the general society. They experience difficulties in saving and coping with unexpected expenses. Caregivers (the parents) experience high stress, low social participation, low financial support from family, friend and non-governmental organizations and decreased well-being. They are highly dependent on social security allowances which constituted 40% of the household's income. Conclusions: Households' dependency on social security allowances may seem contradictory to the encouragement of persons with intellectual disabilities to favor independent living in light of the human rights approach to disability. New policy should aim at reducing caregivers' stress and enhance their social participation and support, with special emphasis on families of lower socio-economic status. Finally, there is a need to continue monitoring the economic and psycho-social needs of households of families of children with intellectual disabilities and other developmental disabilities.

Keywords: disability policy, family policy, intellectual and developmental disabilities, Israel, households study, parents of children with disabilities

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Authors: Nils Haglund, Svenolof Dahlgren, Maria Rastam, Peik Gustafsson, Karin Kalien

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In Sweden, like in most developed countries, there is a substantial increase of children diagnosed with autism and other conditions within the autism spectrum (ASD). The rapid increase of ASD rates stresses the importance of developing care programs to provide support and comprehensive interventions for affected families. The current observational study was conducted in order to evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with autism in southern Sweden. The change in autism symptoms among children participating in CIEI (intervention group, n=67) was compared with children who received traditional habilitation services only (comparison group, n=27). Children of parents who accepted the offered CIEI-program, constituted the intervention group, whereas children, whose parents (for some reason) were not interested in the offered CIEI-program, constituted the comparison group. The CIEI-program was individualized to each child by experienced applied behavior analysis (ABA) specialists with different backgrounds as psychologists, speech pathologists or special education teachers, in cooperation with parents and preschool staff. Due to the individualization, the intervention could vary in intensity and techniques. The intensity was calculated to 15-25 hours each week at home and the preschool altogether. Each child was assigned one 'trainer', who was often employed as a preschool teacher but could have another educational background. An agreement between supervisor- parents and preschool staff was reached to confirm the intensity and content of the CIEI- program over an approximately two-year intervention period. Symptom changes were measured as evaluation-ADOS-2-scores, total- and severity-scores, minus the corresponding baseline-scores, divided by the time between baseline and evaluation. The difference between the study-groups regarding change of ADOS-2-scores was estimated using ANCOVA. In the current study, children in the CIEI-group improved their ADOS-2-total scores between baseline and evaluation (-0.8 scores per year; 95%CI: -1.2 to -0.4), whereas no such improvement was detected in the comparison group (+0.1 scores per year; 95%CI: -0.7 to +0.9). The change difference (change in the CIEI-group vs. change in the comparison group) was statistically significant, both crude and after adjusting for possible confounders (-1.1; 95%CI -1.9 to -0.4). Children in the CIEI-group also significantly improved their ADOS-calibrated severity scores, but not significantly differently so from the comparison group. The results from the current study indicate that the CIEI program significantly improves social and communicative skills among children with autism and that children with developmental delay could benefit to a similar degree as other children. The results support earlier studies reporting on the improvement of autism symptoms after early intensive interventions. The results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. Such results may be of immediate importance to healthcare organizations when allocating the already strained resources to different patient groups. Albeit the obvious limitation of the current naturalistic study, the results support previous positive studies and indicate that children with autism benefit from participating in early comprehensive, intensive programs and that investments in these programs may be highly justifiable.

Keywords: autism symptoms, ADOS-scores, evaluation, intervention program

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Authors: Michael Luc Andre, Célia Maintenant

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Theory of mind is a milestone in child development which allows children to understand that others could have different mental states than theirs. Understanding the developmental stages of theory of mind in children leaded researchers on two Connected research problems. In one hand, the link between executive function and theory of mind, and on the other hand, the relationship of theory of mind and syntax processing. These two lines of research involved a great literature, full of important results, despite certain level of disagreement between researchers. For a long time, these two research perspectives continue to grow up separately despite research conclusion suggesting that the three variables should implicate same developmental period. Indeed, our goal was to study the relation between theory of mind, executive function, and language via a unique research question. It supposed that between executive function and language, one of the two variables could play a critical role in the relationship between theory of mind and the other variable. Thus, 112 children aged between three and six years old were recruited for completing a receptive and an expressive vocabulary task, a syntax understanding task, a theory of mind task, and three executive function tasks (inhibition, cognitive flexibility and working memory). The results showed significant correlations between performance on theory of mind task and performance on executive function domain tasks, except for cognitive flexibility task. We also found significant correlations between success on theory of mind task and performance in all language tasks. Multiple regression analysis justified only syntax and general abilities of language as possible predictors of theory of mind performance in our preschool age children sample. The results were discussed in the perspective of a great role of language abilities in theory of mind development. We also discussed possible reasons that could explain the non-significance of executive domains in predicting theory of mind performance, and the meaning of our results for the literature.

Keywords: child development, executive function, general language, syntax, theory of mind

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