The transition to school: adaptation in young children with and without intellectual disability

The relationship between below average cognitive ability at age 5 years and the child's experience of school at age 9

Background

At age 5, while only embarking on their educational journey, substantial differences in children's cognitive ability will already exist. The aim of this study was to examine the causal association between below average cognitive ability at age 5 years and child-reported experience of school and self-concept, and teacher-reported class engagement and emotional-behavioural function at age 9 years.

Methods

This longitudinal cohort study used data from 7,392 children in the Growing Up in Ireland Infant Cohort, who had completed the Picture Similarities and Naming Vocabulary subtests of the British Abilities Scales at age 5. Principal components analysis was used to produce a composite general cognitive ability score for each child. Children with a general cognitive ability score more than 1 standard deviation (SD) below the mean at age 5 were categorised as 'Below Average Cognitive Ability' (BACA), and those scoring above this as 'Typical Cognitive Development' (TCD). The outcomes of interest, measured at age 9, were child-reported experience of school, child's self-concept, teacher-reported class engagement, and teacher-reported emotional behavioural function. Binary and multinomial logistic regression models were used to examine the association between BACA and these outcomes.

Results

Compared to those with TCD, those with BACA had significantly higher odds of never liking school [Adjusted odds ratio (AOR) 1.82, 95% CI 1.37-2.43, p < 0.001], of being picked on (AOR 1.27, 95% CI 1.09-1.48) and of picking on others (AOR 1.53, 95% CI 1.27-1.84). They had significantly higher odds of experiencing low self-concept (AOR 1.20, 95% CI 1.02-1.42) and emotional-behavioural difficulties (AOR 1.34, 95% CI 1.10-1.63, p = 0.003). Compared to those with TCD, children with BACA had significantly higher odds of hardly ever or never being interested, motivated and excited to learn (AOR 2.29, 95% CI 1.70-3.10).

Conclusion

Children with BACA at school-entry had significantly higher odds of reporting a negative school experience and low self-concept at age 9. They had significantly higher odds of having teacher-reported poor class engagement and problematic emotional-behavioural function at age 9. The findings of this study suggest BACA has a causal role in these adverse outcomes. Early childhood policy and intervention design should be cognisant of the important role of cognitive ability in school and childhood outcomes.

The Transition to Kindergarten for Hispanic and Latine Autistic Children: A Focus Group Study with Caregivers

PURPOSE

Past research highlights the different facilitators and barriers that caregivers of children on the autism spectrum experience during the transition to kindergarten and when navigating special education services. Caregivers who identify as Hispanic and/or Latine may face distinct challenges during this process, such as language differences, differences in understanding autism and special education, and barriers to advocating for their child. Hispanic and Latine caregivers also have strengths, resources, and strategies (i.e. cultural capital) that they use during this time. However, there is little research aimed at understanding the unique experiences of Hispanic and Latine caregivers of autistic children during their entry to kindergarten.

METHODS

To address this shortcoming, the current study used qualitative methods and thematic analysis to explore the transition to kindergarten experiences of four caregivers of autistic children.

RESULTS

This study identified strengths, supportive practices, and challenges that participants experienced fell under four major themes: importance of proactive and ongoing partnerships between caregivers and schools, navigating unfamiliar language and processes, the need for dissemination of information about autism to teachers and support from trusted systems. Themes highlighted challenges such as communication differences, unfamiliar school processes, community and teacher misconceptions about autism. Facilitators the transition included proactive communication, shared goals and partnerships with school. Yosso's Community Cultural Wealth Framework is integrated into the discussion of themes and the forms of cultural capital participants used to support their child.

CONCLUSION

Recommendations for practice and research to support Hispanic and Latine autistic children during the kindergarten transition are provided.

Social Interaction Profiles Among Youth with Intellectual Disabilities: Associations with Indicators of Psychosocial Adjustment

This study investigates the nature of the social interaction profiles observed among youth with intellectual disabilities (ID), defined while considering their relationships with their parents, peers, and teachers, as well as the implication of these profiles for self-esteem, aggressive behaviors, and prosocial behaviors. A sample of 393 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged between 11 and 22 (M = 15.70), was recruited in Canada (n = 141) and Australia (n = 253). Our results revealed four profiles, corresponding to Socially Isolated (23.24%), Socially Integrated (39.83%), Socially Rejected (28.37%) and Socially Connected (8.57%) youth with ID. The socially integrated and connected profiles both presented higher self-esteem, more prosocial behaviors, and less aggressive behaviors than the socially isolated and rejected profiles.

Associations Between Parenting Behaviors and Behavioral Problems in Young Children With Developmental Delays

Children with developmental delays (DD) are at heightened risk for developing behavior problems, which contribute to parenting stress and caregiving burden. There is an established relation between parenting behaviors and child developmental outcomes with less known about parent-child interactions in young children with DD. The present study examined the associations between parenting behaviors and child behavior in a sample of 180 families with preschool-aged children with DD. Results indicated that caregivers' harsh and coercive behaviors were associated with observed challenging behavior in children. Child age, as well as the number of commands issued by caregivers were associated with noncompliance in children. The significance and limitations of these findings are discussed, as well as recommendations for interventions and future research.

How does sensitivity influence early executive function? A critical review on hot and cool processes

There is compelling evidence that the quality of caregiver-child interactions during toddlerhood and the preschool years supports the development of executive function (EF) (Bernier et al., 2010; 2015; 2016; Fay-Stammbach et al., 2014; Geeraerts et al., 2021). Based on such findings, we make the case herein that sensitivity may be one of the most important dimensions of parenting contributing to early EF. In the present article, we will review empirical evidence, integrating findings from a wide range of scientific disciplines - cognitive psychology, neuroscience, and developmental psychopathology - and present theoretical ideas about how two contexts of sensitive caregiving - i.e. sensitivity to distress and non-distress cues - may be contributing differently to hot and cool EF development. Implications for future investigations on the environmental contributors of early EF, and its mechanisms, are discussed.

Meta-analytic associations between the Student-Teacher Relationship Scale and students' social competence with peers

According to developmental psychologists, more supportive and less conflictual relationships with teachers play a positive role in children's social behavior with peers both concurrently and in the future. This meta-analysis examined the association between teacher-student relationship quality, as measured by the Student-Teacher Relationship Scale (STRS; Pianta, 2001a), and social competence from early childhood through high school. Based on nearly 30,000 students from 87 studies, the weighted average association between teacher-student relationship quality and social competence with peers was r = .31 (z = .32; 95% CI: .28, 37). Neither age nor length of time between assessments were associated with effect size, suggesting that teacher-student relationships continue to be associated with children's social competence beyond the early years. Additionally, the STRS total score was the best predictor of social competence, whereas dependency was more weakly associated with social competence. The findings of this study suggest that teacher-student relationship quality as measured by the STRS is an important correlate of both concurrent and future social competence from early childhood to adolescence.

Treating sleep problems in young children: A randomised controlled trial of a group-based, parent-focused behavioural sleep intervention

This study tested the efficacy of a 5 × 1.5 h/session, group-based, parent-focused, behavioural intervention (BI) targeting sleep problems in preschool children. Parents were randomised to either the BI (N = 62) or care as usual (CAU; N = 66) conditions. Outcomes included sleep, anxiety, behavioural problems, internalising and externalising symptoms, transition to school and academic achievement. Assessments were conducted at pre- and post-BI intervention (in the year prior to formal schooling), and then at follow-ups 1 and 2 in the first year of formal schooling. Relative to the CAU, the BI condition demonstrated significantly greater improvements in sleep, anxiety, behaviour problems and internalising and externalising symptoms from pre-to post-intervention. Improvements in sleep, anxiety, and internalising symptoms were maintained, while behaviour and externalising symptoms were further improved upon at school follow-up 2. For the BI group, improvements in sleep at post-intervention were found to mediate improvements in anxiety, internalising, and externalising symptoms, but not behaviour problems, at school follow-ups 1 and 2. There were no significant effects of condition on school transition or academic outcome measures. The results suggest that the BI is effective for sleep, anxiety, behaviour, internalising and externalising symptoms, but not for school transition or academic outcomes. ANZCTR NUMBER: ACTRN12618001161213.

Examining early learners' perceptions of inclusion: adaptation of the student version of the perceptions of inclusion questionnaire for first- and second-grade students (PIQ-EARLY)

Promoting the emotional and social development of students with and without special needs is a central goal of implementing inclusive education in the school system. The entry into school, and thus into the formal education system, is accompanied by emotions and changes in self-image and social relationships. For assessing emotional inclusion, social inclusion, and academic self-concept, the Perceptions of Inclusion Questionnaire (PIQ) is a widely used instrument. To date, the paper-pencil questionnaire has been used from third through ninth grades but has not yet been used with younger ages. This paper presents an adapted version of the PIQ for first- and second-grade students, which was used on two measurement time occasions (T1, N = 407, M_Age = 7.2; T2, N = 613, M_Age = 7.6). Information on students' reading and listening comprehension was collected from the class teachers to verify whether the adapted questionnaire can be used for all students with different levels of language competencies. Measurement invariance was demonstrated to be at least scalar for all groups considered in the analyses. Students with higher rankings of reading and listening comprehension skills reported significant higher levels of emotional inclusion and academic self-concept while there were no significant differences in social inclusion. The findings suggest that the PIQ-EARLY is a suitable instrument for assessing self-perceived inclusion in first- and second-grade students. The results also highlight the importance of students' language competencies for adjustment to school in early school years.

Facilitators of Sense of Belonging Among People With Intellectual and Developmental Disabilities: A Systematic Review

Background: This review synthesizes the available literature regarding factors which facilitate a sense of belonging in people with intellectual and developmental disabilities, and provide a comprehensive integrative view of the subject. Methods: Four electronic databases were searched, and 13 studies met inclusion criteria for review. The "standard quality assessment criteria for evaluating primary research papers from a variety of fields" indicated satisfactory quality. Factors which facilitate a sense of belonging in people with intellectual and developmental disabilities were analyzed into themes. Results: Sense of belonging is enhanced by feeling respected, accepted, and valued (Subjectivity). These experiences are more likely to be achieved in a familiar and safe environment (Dynamism), and with access to platforms for social interactions (Groundedness), where a sense of relatedness and connectedness achieved by shared experiences with others (Reciprocity). Sense of belonging is associated with committed action of people with disability, taking assertive action or being agentic (Self-determination). Conclusion: Sense of belonging is a unique concept that should be addressed in disability research and practice.

The development and validation of a questionnaire on parental involvement in the transition from kindergarten to primary school for children with developmental disabilities in China

BACKGROUND

At present, there is a lack of valid and reliable instruments that can measure parental involvement in the transition from kindergarten to primary school of children with developmental disabilities (DD) in China.

AIM

This study seeks to develop and validate the questionnaire on Parental Involvement in Transition from Kindergarten to Primary School (PITKPS) for children with DD in China.

METHODS

A total of 241 parents of children with DD participated in Study 1, and another 247 parents participated in Study 2. In study 1, we used item analysis and exploratory factor analysis to screen items and explore the factor structure of the PITKPS questionnaire. In study 2, three types of validity were examined: construct validity; convergent and discriminative validity; and criterion-related validity. Internal consistency was used to measure reliability.

RESULTS

The final version of the PITKPS questionnaire comprised 37 items that examined six factors. Confirmatory factor analysis supported the use of the six-factor model, and the results indicated that the questionnaire had good reliability and validity.

CONCLUSIONS

The PITKPS questionnaire can be used as a valid tool to assess the involvement of Chinese parents in the transition from kindergarten to primary school of children with DD.

Inclusive physical activity games at school: The role of teachers’ attitude toward inclusion

Introduction

Inclusive physical activity games at school can be useful for teachers dealing with students with disabilities. The use of inclusive strategies and games can be directly linked to teachers’ self-efficacy and familiarity with the inclusive strategies, while it could be indirectly influenced by their attitude toward inclusion and, in a smaller part, by social desirability in their response. Moreover, teachers’ responses could be different among the different school grades. Therefore, the aim of the current study is to investigate the role of attitude toward inclusion, social desirability, self-efficacy, and familiarity in the use of physical activity games at school in teachers from all school grades.

Methods

A sample of 1,583 schoolteachers was asked to fill out a questionnaire about their perceptions of governmental measures, self-efficacy, familiarity with inclusive strategies through physical activity, and two standardized questionnaires assessing attitudes toward inclusion and social desirability.

Results

Teachers from primary school reported lower scores in attitude toward inclusion total score and dimensions, namely impact on teacher, impact on the environment, impact on the other children, and impact on the student with disability. Moreover, the path analysis model showed that the attitude toward inclusion indirectly influenced the use of inclusive strategy and had a small direct effect on familiarity with inclusive strategies and self-efficacy. Social desirability slightly influenced both familiarity and self-efficacy but not the use of inclusive strategies. Familiarity and self-efficacy had a direct effect on the use of inclusive physical activity games.

Discussion

The results of the current study suggest that being familiar with and having a high self-efficacy in implementing inclusive strategies are well related to the use of inclusive strategies at school. In addition, more attention should be given to kindergarten and primary school teachers, who reported lower scores in the attitude toward inclusion and higher scores in social desirability.

Transition to Kindergarten for Children on the Autism Spectrum: Perspectives of Korean-American Parents

This study explores Korean-American parents' perceptions on successful transition to kindergarten (TTK) for their child on the autism spectrum. It further examines challenges experienced during this process, and possible predictors for their challenges. Findings from an online survey (N = 212) indicate that participants consider their child's behavioral readiness and cooperation with teachers as the most important school readiness skills for successful TTK. They further consider building positive relationships with teachers and providing support at home as the most important support parents could provide during this process. Moreover, the child being a vocal communicator, higher income and parent's educational level were found to buffer against their reported challenges, while first-generation immigrant status and restrictive school placement were found to predict more challenges.

Application of a Bayesian Network Learning Model to Predict Longitudinal Trajectories of Executive Function Difficulties in Elementary School Students

Executive function is the mental ability to modulate behavior or thinking to accomplish a task. This is developmentally important for children's academic achievements and ability to adjust to school. We classified executive function difficulties (EFDs) in longitudinal trajectories in Korean children from 7 to 10 years old. We found predictors of EFDs using latent class growth analysis and Bayesian network learning methods with Panel Study data. Three types of latent class models of executive function difficulties were identified: low, intermediate, and high EFDs. The modeling performance of the high EFD group was excellent (AUC = .91), and the predictors were the child's gender, temperamental emotionality, happiness, DSM (Diagnostic and Statistical Manual of Mental Disorders) anxiety problems, and the mother's depression as well as coparenting conflict recognized by the mother. The results show that using latent class growth analysis and Bayesian network learning are helpful in classifying the longitudinal EFD patterns in elementary school students. Furthermore, school-age EFD is affected by emotional problems in parents and children that continue from early life. These findings can support children's development and prevent risk by preclassifying children who may experience persistent EFD and tracing causes.

Relationships Among Maternal Interactive Behaviors, Preschoolers’ Hot and Cool Executive Function, and Conscience

Objectives: Preschoolers’ conscience refers to a concept revolving around moral emotion, cognition and behavior. This study investigates the relationships among preschoolers’ conscience, hot and cool executive function, and maternal interactive behaviors. Furthermore, it examines the mediating role of preschoolers’ executive function in the relationship between maternal interactive behaviors and preschoolers’ conscience.Methods: Participants comprised 220 mothers and teachers engaging with preschoolers. Data were collected during the COVID-19 period. Therefore, a research process, which suited the changing operations of day-care centers and kindergartens due to social distancing, was adopted. The mothers answered questionnaires on preschoolers’ conscience and maternal interactive behaviors, and the teachers on hot and cool executive function. Obtained data were analyzed using correlations, multiple regression, hierarchical regression, and bootstrapping.Results: Results revealed that the preschoolers’ conscience was significantly related to maternal interactive behaviors and preschoolers’ hot and cool executive function. The preschoolers’ executive function mediated the effect of maternal interactive behaviors on their conscience. Specifically, the plannning and organizing of the executive function fully mediated the relationship between maternal efficient interactive behaviors and preschoolers’ internalized conduct. The bootstrapping result suggested that the indirect effect is statistically significant.Conclusion: This study explored an area of morality that is less researched and incorporated the importance of executive function into it. Additionally, the results confirmed the mediating effect of preschoolers’ executive function on their conscience. The results obtained are expected to help organize activities for developing morality.

Development of Social Skills in Kindergarten: A Latent Class Growth Modeling Approach

Social skills acquired during early childhood are often the foundation for success later in life. Using a nationwide survey dataset in Japan, this study aims to explore the multiple growth trajectories of social skills among children in kindergarten by using a latent class growth modeling approach. It also examines whether, and to what extent, the home-rearing environment at early age predict trajectories of social skills development. Children in this study were assessed on social skills at three waves, four home-rearing environment dimensions (human stimulation, social stimulation, avoidance of punishment, and social support for parenting) and demographic background were measured at wave 1. The results indicated that three distinct growth trajectories of social skills existed during kindergarten: high increase levels, moderate increase levels, and decreased levels. The avoidance of punishment and children's gender significantly predicted the growth trajectories of social skills. Thus, the results suggest that more attention should be paid to the home-rearing environment and boys.

School-entry language skills as predictors of concurrent and future academic, social, and adaptive skills in kindergarteners with ASD

OBJECTIVE

This study compared language profiles of children with autism spectrum disorder (ASD) and typically developing (TD) children at kindergarten-entry and investigated whether kindergarten-entry language scores were predictive of concurrent and future academic achievement, peer interactions, and adaptive skills in children with ASD.

METHOD

Participants included 97 children (62 children with ASD; 35 TD children) assessed at kindergarten-entry and -exit. Language abilities were assessed using the Children's Communication Checklist-2 (CCC-2). Children with ASD and TD children's language scores were compared at baseline, and the ASD group was followed longitudinally. Regression analyses were performed to compare language scores between ASD and TD groups and to predict concurrent and future functional skills from kindergarten-entry language scores for children with ASD.

RESULTS

Children with ASD demonstrated significantly more impairments across all scales of the CCC-2 at kindergarten-entry compared to TD children. Within the ASD group, kindergarten-entry pragmatic language significantly predicted concurrent math and reading achievement. Both syntactic/semantic and pragmatic domains significantly predicted kindergarten-exit reading performance; pragmatics significantly predicted kindergarten-exit math performance. Pragmatics also predicted concurrent and kindergarten-exit peer play. Syntax/semantics significantly predicted concurrent adaptive communication skills, whereas pragmatics significantly predicted concurrent adaptive daily living and socialization skills, as well as kindergarten-exit socialization skills.

CONCLUSIONS

School-entry language abilities can serve as a valuable predictor of functional outcomes across the kindergarten year for cognitively-able children with ASD. Results highlight the need to target early language abilities to maximize academic, social, and adaptive skills.

Toward a Comprehensive Assessment of Relationships with Teachers and Parents for Youth with Intellectual Disabilities

This study proposes a multi-informant (youth, teachers, and parents) measure of relationship quality with adults for youth with intellectual disabilities (ID). A sample of 395 youth with mild (49.15%) and moderate (50.85%) ID, aged 11-22 (M = 15.82) was recruited in Canada (French-speaking, N = 142), and Australia (English-speaking, N = 253). Results support the reliability, factor validity, discriminant validity (in relation to sex, ID level, country, and comorbidity), convergent validity (depression, anxiety, aggressiveness, and prosocial behaviors), and one-year longitudinal stability of the measure. Youth self-reports provide a complementary perspective on relationship quality with adults relative to teachers' or parents' reports, whereas teachers and parents seem unable to differentiate their own perspective from that of the target youth.

The effect of functioning on Quality of Life Inventory-Disability measured quality of life is not mediated or moderated by parental psychological distress

PURPOSE

The measurement of quality of life (QOL) in children with intellectual disability often relies upon proxy report via caregivers. The current study investigated whether caregiver psychological distress mediates or moderates the effects of impairment on their ratings of QOL in children with intellectual disability.

METHODS

Caregivers of 447 children with an intellectual disability reported their child's day-to-day functioning, their own psychological distress using the Kessler Psychological Distress Scale, and the Quality of Life Inventory-Disability (QI-Disability), a measure of QOL for proxy report of a child's observable behaviours that indicate quality of life. Linear regression was used to assess the effects of the child's functional abilities on their QI-Disability score and causal mediation analysis to estimate the extent to which these effects were mediated by caregivers' psychological distress.

RESULTS

A minority of caregivers (n = 121, 27.1%) reported no psychological distress. Lower day-to-day functional abilities, such as being fully dependent on others to manage their personal needs were associated with lower total QOL scores. There was no significant mediation effect of caregiver psychological distress on the association between child functioning and total QOL scores. Moderation analyses revealed small and largely nonsignificant interaction coefficients, indicating that caregiver psychological distress did not influence the strength of the relationship between child functioning and total QOL scores.

CONCLUSION

Caregiver psychological distress did not mediate or moderate the relationship between the level of functional abilities and QOL in children with intellectual disability. QI-Disability measured observable child behaviours which may reduce the influence of caregiver factors on the accurate measure of QOL for children with intellectual disability.

Participation of young children with developmental disabilities: parental needs and strategies, a qualitative thematic analysis

OBJECTIVES

Participation refers to a person's involvement in activities and roles that provide interaction with others as well as engagement in family and community activities. Young children with developmental disabilities (DD) such as attention deficit hyperactive disorder, autism spectrum disorder and developmental coordination disorder are limited in their participation compared with their typically developing peers. This study aimed to obtain information regarding parental needs and strategies used to enable their child's participation.

DESIGN

A thematic inductive approach with in-depth interviews was used to explore parental experiences. Eleven women and two men, between 30 and 40 years of age, who had a child (4-9 years old) with a DD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders criteria, participated in semistructured interviews.

RESULTS

Two central themes emerged: parental needs and parental strategies used to enable their child's participation. Parental needs were the following: increasing awareness, ameliorating parental burden, providing tailored interventions and supporting parents in finding suitable leisure activities. Parental strategies aimed at increasing their child's resiliency, attaining maximal fit between activity requirements and child capacity, and creating inclusive opportunities and awareness.

CONCLUSIONS

Understanding what families' needs are and how families use and integrate strategies within the context of their daily lives provides practitioners with insights needed to support families' resiliency in promoting their children's participation. The results have implications for professionals as this information can be used to inform, refine, or tailor participation-based and family-centred services.

"The big wide world of school": Supporting children on the autism spectrum to successfully transition to primary school: Perspectives from parents and early intervention professionals

Background:

The transition to primary school is often a complex and uncertain time for autistic children and their families. Understanding how best to develop school readiness and support transition to primary school for autistic children is essential. School readiness and transition planning are influenced by a range of personal and contextual factors, and it is important to understand the perspectives of the various stakeholders involved in the transition process.

Methods:

A qualitative exploration employing focus groups and interviews was undertaken with early intervention (EI) staff (n = 45) and parents (n = 18) across Australia to understand their perspectives on school readiness and the transition to primary school.

Results:

Thematic analysis identified four emerging themes facilitating transition including: 1) building the child; 2) building the parents; 3) building the receiving school; and, 4) connecting the system.

Conclusion:

Findings highlight the need to consider school readiness and transition planning from a holistic perspective, ensuring clear, collaborative and ongoing communication between parents, teachers and EI staff, using a strength-based approach, and individualizing transition planning.

Coparenting and Child Outcomes in Families of Children Previously Identified With Developmental Delay

The current study explored cross-sectional relations between coparenting quality and child problem behaviors, as measured by parent report and direct observation, in families of school-aged children previously identified with a developmental delay in early childhood. Parents' reports of difficulty with coparenting problems predicted child problem behaviors. For primary caregivers, parenting self-efficacy mediated the relation between coparenting quality and problem behaviors. Observed undermining behavior significantly positively predicted child appropriate behavior across specific tasks and observed partner support behavior significantly negatively predicted child appropriate behavior across specific tasks. Discussion focuses on the clinical significance of these findings and future research directions.

The impact of persistent pediatric obstructive sleep apnea on the Quality of Life of Patients' families

OBJECTIVES

To (1) quantify the quality of life (QOL) for families of children affected by persistent obstructive sleep apnea (OSA), and (2) assess factors contributing to the negative impact of OSA on families.

METHODS

Prospective case series in a multidisciplinary upper airway center at a tertiary pediatric institution. Our study included patients with persistent OSA referred to our clinic from 2014 to 2016. Both patients and their families completed validated questionnaires assessing QOL and OSA symptoms, including the Family Impact Questionnaire (FIQ), Pediatric Sleep Questionnaire, the Pediatric Quality of Life Inventory, the OSA-18, and the Epworth Sleepiness Scale.

RESULTS

Families of 67 patients were included. The mean patient age was 12.5 (95%CI 11.9-13.1); 23 (34.3%) were female, and the mean BMI percentile was 80.2 (95%CI 73.6-86.8). The single most common comorbidity was Down syndrome (45.6%). The mean obstructive apnea-hypopnea index was 9.7 ± 10.3 events/hour. A significant association exists between OSA severity and 18 FIQ negative subscore (P < 0.001). Financial impact was the primary negative concern for parents of patients with OSA compared to those without OSA (P = 0.03). There were no other significant differences between those with and without OSA.

CONCLUSIONS

There was a significant correlation between persistent OSA severity and the FIQ negative impact of disease score on patients' families. Concern regarding financial burden was more common for families of children with OSA than for those without OSA. This suggests that targeted interventions, particularly regarding the financial burden of persistent OSA diagnosis and management, may provide some relief to families.

Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages

This study aimed to investigate cognitive and behavioral outcomes in relation to gestational age (GA) in school-aged children born preterm (PT). Results from the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV), and the Child Behavior Checklist (CBCL) were analyzed in 51 children (mean age: 7.8 years [range: 7.0-8.7]) born PT (mean GA: 31 weeks [range: 23-35]; birth weight, mean: 1,637 g [range: 404-2,962]) with the majority (96%) having no diagnosed cognitive, sensory, or motor impairments. The control group included 57 age-matched typically developing children (mean age: 7.9 years [range: 6.2-8.7]) born full-term (FT). Children born PT, extremely PT (GA < 28) in particular, showed significantly lower cognitive performance and higher behavioral problem scores compared with children born FT. GA was found to predict aspects of both cognitive functioning and behavioral problems within the PT group, with lower GA being related to both poorer cognitive outcomes and elevated affective and attention-deficit/hyperactivity problems. Global cognitive functioning did not independently predict aspects of behavioral outcomes. Findings demonstrate that, even in children born PT without severe perinatal and/or postnatal complications and receiving active perinatal care, a short gestation is an evident risk factor for long-term negative effects on mental health independent of cognitive functioning. Additional findings suggest that both reduced growth and lower parental educational level may contribute to increased risk for poorer cognitive and behavioral functioning in children born PT.

Early Communication Skills and Special Education Outcomes at School Entry: Implications for Pediatric Care and Screening

Objective. To examine whether children's early communication skills at age 3 predict special education outcomes at kindergarten entry. Methods. Data from 139 children eligible for early intervention or early childhood special education services were examined. Early communication was defined separately as expressive and receptive language skills and was measured by the Vineland Adaptive Behavior Scales-Second Edition. Outcome variables were parent-reported measures of special education use and dosage as well as speech therapy receipt and dosage at kindergarten entry. Results. Better expressive language skills at age 3-but not receptive language skills-predicted a significantly reduced likelihood (odds ratio = 0.79) of receiving speech therapy at kindergarten entry. There were no effects of early communication on broader receipt of special education services as well as on special education dosage. Conclusions. Screening of specific domains of early communication skills during routine pediatric care, in conjunction with the evaluations of other professionals involved in the child's education and health, might be an effective method for identifying children who are likely to receive speech therapy and other special education services at kindergarten entry.

The Transition to School Among Deaf/Hard-of-Hearing Children: Teacher and Parent Perspectives

Although entry into the school system is a major milestone in the lives of young d/Deaf or hard-of-hearing (DHH) children and their families, relatively little is known about parents' and teachers' experiences and perspectives of this important transition. The aims of this study were to describe parents' concerns during their children's transition from early intervention to school, to describe practices available for families of DHH children, and to explore parents' and teachers' perspectives regarding practices that support a smooth transition to school. Parents (N = 40) and teachers (N = 37) of the deaf and hard of hearing completed surveys examining their experiences and perspectives on DHH children's transition to school. Among concerns expressed among parents was their child's ability to participate successfully in an inclusive school setting, as well as the level of supports their child would receive. Teachers reported numerous policies and practices that supported the transition to school, emphasizing high-intensity practices often used to gather information about the child and set accommodations in place. Parent and teacher reports on facilitators for the transition are compared and contrasted. Recommendations for research and practice are provided.

Children's Emotional Self-Regulation in the Context of Adversity and the Association with Academic Functioning

The aims of this study were to study reciprocal interactions between emotion regulation skills, association of these skills with children's school functioning and how these underlying skills develop in children in the context of adversity. 48 children (mean age = 5 years 8.2 months) were divided into an adversity risk group and a low-risk group. Emotional regulation was assessed via an emotion identification task, a Stroop task and near-infrared spectroscopy. School functioning was documented using the Social Skills Improvement System with parents and teachers. During the Stroop task, there was a difference in the activation of the right Brodmann area 8 in both groups. During the emotion regulation tasks, BA8L and BA9R showed activation and an association with school functioning. These results contribute to the accuracy of cerebral mapping associated with emotion regulation and support its potential contribution in preventive programs aimed at the functioning of children at risk of school difficulties.

Evaluation and training of Executive Functions in genocide survivors. The case of Yazidi children

Executive Functions (EFs) development is critically affected by stress and trauma, as well as the socioeconomic context in which children grow up (Welsh, Nix, Blair, Bierman, & Nelson, 2010, Journal of Educational Psychology, 102, 43-53). Research in this field is surprisingly lacking in relation to war contexts. This study represents a first attempt at addressing this topic by evaluating EFs in Yazidi children. The Yazidi community is an ethnic and religious minority living in Iraq. From August 2014 onwards, the Yazidi community has been the target of several atrocities perpetrated by ISIS and described as genocide by the international community at large. The University of Trieste, thanks to a program financed by the Friuli Venezia Giulia Region, developed a study aimed at (a) evaluating hot and cool EFs in children living in a war context and (b) developing a specific training method to enhance hot and cool EFs in Yazidi children of preschool age (N = 53). Data related to this group of children were compared with a sample of typically developing Italian children randomly assigned to either an EFs training group (N = 55) or a passive control group (N = 51). Results indicate different baselines in EFs in Yazidi and Italian samples and a significant effect of the program on both trained groups, especially in tasks measuring hot EFs. Data are discussed in terms of hot and cool EFs in children growing in adverse environments, as well as the evaluation of educational and developmental opportunities to prevent children who survived genocide from becoming a 'lost generation'. A video abstract of this article can be viewed at https://youtu.be/7t_08TbxR_8.

Comparison of aural rehabilitation outcomes in presence and absence of back ground noise in hearing impaired children with and without attention deficit hyperactivity disorder (ADHD)

OBJECTIVE

We sought to understand the extend of improvement in seven major skills to determine the best rehabilitation approach in hearing impaired young children with and without attention deficit and hyperactivity disorder (ADHD).

METHODS

Newsha developmental scale was assessed in 40 hearing impaired children with and without ADHD in two conditions, in which seven major skills (hearing, speech, receptive language, expressive language, cognition, social communication, and motor skills) were evaluated. Two separate analyses were conducted, each after six months of rehabilitation. The first six months rehabilitation was done by controlling background noise level, while the other six months rehabilitation was performed with background multi talker babble noise, and ADHD and non ADHD children performance were compared.

RESULTS

After the first six months of rehabilitation there were no significant difference in improvement in any of the major skills except for motor and cognition skills between hearing impaired ADHD and non ADHD children. After the second six months of rehabilitation the extend of improvement was equal in both groups.

CONCLUSION

The equal improvement of hearing impaired ADHD and non- Children with ADHD support the benefits of rehabilitation program in both groups. In addition, it seems background multi talker babble noise can facilitate the process of rehabilitation in ADHD group. As a result, it is important to understand the specific needs of hearing impaired children with ADHD in rehabilitation program to provide the best services and increase the chance for success.

Hot and Cool Executive Functions in Adolescence: Development and Contributions to Important Developmental Outcomes

Despite significant theoretical advancement in the area of child neuropsychology, limited attention has been paid to the developmental features of adolescence. The present study intends to address this issue in relation to executive function (EF). EF refers to the psychological processes that underlie goal-directed behavior; recent studies separate cool EF (psychological process involves pure logic and critical analysis) and hot EF (psychological process driven by emotion). Although neurological findings suggest that adolescence is a sensitive period for EF development, data on comparing the developmental progression in hot or cool EFs is highly missing. Moreover, while evidence has confirmed the relationships between EF and day-to-day functioning, whether and how hot and cool EFs contribute to core developmental outcomes in adolescence is still remained unknown. The current study aims to enhance our understanding of the development and impacts of hot and cool EFs in adolescence. A total of 136 typically developing adolescents from age 12 to 17 completed four cool EF tasks including Backward digit span, Contingency naming test, Stockings of Cambridge, and Stroop Color and Word test, and one hot task on Cambridge gambling task. Data on academic performance and psychological adjustment was also collected. Results showed that cool and hot EF exhibited different patterns of age-related growth in adolescence. Specifically, cool EF ascended with age while hot EF showed a bell-shaped development. Moreover, there were correlations among cool EF measures but no association between cool and hot EFs. Further, cool EF was a better predictor of academic performance, while hot EF uniquely related to emotional problems. The results provide evidence for the association among cool EF tests and the differentiation of hot and cool EFs. The bell-shaped development of hot EF might suggest a period of heightened risk-taking propensity in middle adolescence. Given the plastic nature of EF, especially over adolescence, the current findings may have practical implications for future EF identification and training.

Examining young children's social competence using functional ability profiles

PURPOSE

To explore the use of International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) based profiles of children's functional abilities in relation to their social competence. Subgroups based on shared profiles of functional ability were investigated as an alternative or complement to subgroups defined by disability categories.

METHODS

Secondary analysis of a nationally representative data set of young children identified for special education services in the United States was used for the present study. Using five subgroups of children with shared profiles of functional ability, derived from latent class analysis in previous work, regression analyses were used to examine the relationships between social competence and functional abilities profile subgroup membership. Differences among the subgroups were examined using standardized effect sizes. R² values were used to examine explained variance in social competence in relation to subgroup membership, disability category, and these variables in combination.

RESULTS

Functional ability profile subgroup membership was moderately related to children's social competence outcomes: social skills and problem behaviors. Effect sizes showed significant differences between subgroups. Subgroup membership accounted for more variance in social competence outcomes than disability category.

CONCLUSIONS

The results provide empirical support for the importance of functional ability profiles when examining social competence within a population of young children with disabilities. Implications for Rehabilitation The extent to which children with disabilities experience difficulty with social competence varies by their functional characteristics. Functional ability profiles can provide practitioners and researchers working young children with disabilities important tools to examine social competence and to inform interventions.

Relation between working memory and self-regulation capacities and the level of social skills acquisition in people with moderate intellectual disability

BACKGROUND

Social competence deficit is one of the main characteristics of intellectual disability. The aim of this paper is to determine the influence of working memory (WM) and self-regulation (SR) on social skills in persons with moderate intellectual disability (MID).

METHOD

The sample included 41 participants with MID, aged 14-21. Memorizing animals and maze tasks were used for WM assessment. SR skills were assessed by the Behavioral Multitask Batteries. Social skills were rated by the Socialization subscale from the Adaptive Behavior Assessment System II, which consists of two parts.

RESULTS

Social skills part could mainly be predicted from SR scores (β = -.441), followed by WM (β = .390) and IQ score (β = .382). Only WM score (β = .494) had a predictive value for Leisure time part.

CONCLUSION

As WM had a greater influence on social skills, incorporating WM training into programmes for improving social skills in persons with MID should be considered.

A new approach to measuring patience in preschoolers

Patience in children has usually been studied using delay of gratification paradigms. However, another important aspect of patience that has not been well documented is the ability to adjust one's behavior while waiting without an explicit reward as a motivator (e.g., sitting in the doctor's waiting room). To examine this aspect of patience, video-recordings of sixty-one 3- and 4-year olds waiting for two separate 3-min periods were examined and coded for children's spontaneous behaviors. We found that 4-year olds displayed more patient (i.e., staying still) behaviors than 3-year olds during this "waiting paradigm." Interestingly, we also found that children who displayed less patient behaviors during the waiting paradigm were also those who succeeded on a future-thinking task. These findings have important implications for measuring patience in young children and highlight the potential impact of spontaneous behaviors on children's performance in cognitive tasks such as those assessing future-oriented cognition.

Participation in Early Childhood Educational Environments for Young Children with and Without Developmental Disabilities and Delays: A Mixed Methods Study

AIMS

This mixed methods study examined: 1) how young children with and without developmental disabilities and delays participate in daycare or preschool activities; 2) similarities and differences in environmental factors impacting daycare or preschool participation; and 3) strategies used by parents who desired a change in their child's participation.

METHODS

Data were drawn from 129 parents of young children with and without developmental disabilities and delays (mean age = 49.3 months) residing in North America. Summary and item-level group differences based on disability status were assessed for participation and environmental supports to participation. Narrative data on parental strategies were content coded, transformed into numerical counts, and summarized to identify strategies commonly employed by parents to promote their child's participation.

RESULTS

Moderate to large disability related group differences in participation and environmental support to participation were found even after controlling for confounding effects of child age, child gender, and family income. Parents commonly described strategies focused on "child care tasks" and "child peer groups," irrespective of the type(s) of change they desired.

CONCLUSIONS

Study findings suggest that discrepancies in school participation between young children with and without disabilities and delays can be detected and intervened on during the early childhood period.

Delay of gratification: a comparison study of children with Down syndrome, moderate intellectual disability and typical development

BACKGROUND

Self-regulation has been found to be an important contributor to a range of outcomes, with delay of gratification (a self-regulatory skill) predicting better academic, social and personal functioning. There is some evidence that individuals with Down syndrome have difficulty with delay of gratification. We investigated the question of whether this difficulty is common to intellectual disability irrespective of aetiology, or whether it presents a particular problem for those with Down syndrome. The latter was considered a possibility because of language difficulties in this group.

METHOD

Three groups of children with a mean MA between 36 and 60 months participated in the study: children with Down syndrome (n = 32), children with a moderate intellectual disability from a cause other than Down syndrome (n = 26) and typically developing children (n = 50). Children completed a series of measures of language and cognitive functioning and participated in a delay of gratification task.

RESULTS

The group of children with Down syndrome delayed for a significantly shorter time than either of the other two groups that did not differ from each other. Receptive language was associated with delay time for the children with Down syndrome but not for the typically developing group, nor for the group with moderate intellectual disability.

CONCLUSIONS

Children with Down syndrome appear to have a particular difficulty with delay of gratification. Language abilities would seem to be implicated in this difficulty, although further examination of this hypothesis is required.

Social cognition makes an independent contribution to peer relations in children with Specific Language Impairment

BACKGROUND

Language is important for developing and maintaining social relationships, and also for understanding others minds. Separate studies have shown that children with Specific Language Impairment (SLI) present difficulties in both abilities, although the role of social cognition (SC) on peers' perception remains unexplored.

AIMS

The present study aims to assess specific sociometric features of children with SLI through peer nominations of liking and disliking, and also to explore their relationship to the children's SC.

METHODS AND PROCEDURES

Thirty-five children with SLI attending ordinary schools (3;10 to 8;00 years old) and thirty-five age-matched children (AM) were assessed with language, SC and sociometric measures.

RESULTS

SLI group received more disliked nominations and had lower scores on SC tasks compared to the AM group. After controlling for age and language, SC made an independent contribution to disliked nominations within the SLI group.

CONCLUSIONS

Difficulties with peers of children with SLI are related to their language level but also with their SC abilities. Consequently, only resolving language impairments will not necessarily improve early peer acceptance in children with SLI.

IMPLICATION

This finding stresses the importance of early intervention programmes aimed at reducing deleterious effects in later development and socialization with peers.

Improving child self-regulation and parenting in families of pre-kindergarten children with developmental disabilities and behavioral difficulties

The transition to school may be particularly difficult for children with developmental disabilities and behavioral difficulties. Such children are likely to experience problems with self-regulation skills, which are critical to school adjustment. Additionally, inconsistent discipline practices and low parental involvement in children's schooling may contribute to a poor transition to school. This study employed a randomized clinical trial to examine the effects of a school readiness intervention that focused on children's self-regulation skills as well as parenting and parental involvement in school. Results showed that the intervention had positive effects on children's self-regulation in kindergarten as measured by teacher and observer reports. Additionally, the intervention significantly reduced ineffective parenting prior to school entry, which in turn affected parental involvement. This finding is significant because it demonstrates that parental involvement in school may be increased by efforts to improve parenting skills in general. Overall, the study demonstrated that school adjustment across kindergarten among children with developmental disabilities and behavioral difficulties can be enhanced through an intervention aimed specifically at improving school readiness skills.

Predictors of distress and well-being in parents of young children with developmental delays and disabilities: the importance of parent perceptions

BACKGROUND

Moving from family-centred to child-centred models of service delivery can be stressful for parents as their young children with developmental delays and disabilities transition into school. The purpose of this paper was to explore and compare predictors of both distress and well-being in parents during this transition period.

METHODS

A sample of 155 mothers of 113 boys and 42 girls participated in the study. The mean age of the children was 4.9 years and their diagnoses included autism spectrum disorder (52%); unspecified intellectual disability/developmental delay (26%); Down syndrome (12%); other genetic conditions (4%) and other diagnoses (6%). Participants completed surveys primarily online focusing on child characteristics, family resources, parent coping strategies, parental distress and positive gain.

RESULTS

Multiple regression analyses were conducted to determine predictors of parent reported distress and positive gain. Parent coping variables were the strongest predictors of both positive gain and parental distress, with reframing emerging as a predictor of positive gain and parent empowerment emerging as a predictor of both greater positive gain and lower parental distress.

CONCLUSIONS

The results of this study highlight not only the importance of including positive as well as negative outcomes in research with parents but also the importance of including parent characteristics such as coping strategies (e.g. reframing and empowerment/self-efficacy) as potential predictors of outcome in such studies.

Your wish is my command! The influence of symbolic modelling on preschool children's delay of gratification

The ability of children to delay gratification is correlated with a range of positive outcomes in adulthood, showing the potential impact of helping young children increase their competence in this area. This study investigated the influence of symbolic models on the self-control of 3-year old children. Eighty-three children were randomly assigned to one of three modelling conditions: personal storytelling, impersonal storytelling, and control. Children were tested on the delay-of-gratification maintenance paradigm both before and after being exposed to a symbolic model or control condition. Repeated measures ANOVA revealed no significant differences between the two storytelling groups and the control group, indicating that the symbolic models did not influence children's ability to delay gratification. A serendipitous finding showed a positive relationship between the ability of children to wait and their production and accurate use of temporal terms, which was more pronounced in girls than boys. This finding may be an indication that a higher temporal vocabulary is linked to a continuous representation of the self in time, facilitating a child's representation of the future-self receiving a larger reward than what the present-self could receive.

Understanding the impact of special health care needs on early school functioning: a conceptual model

Children with special health care needs (SHCN) have or are at increased risk for a chronic condition that necessitates more health and related supports than their peers. While it is generally accepted that these children are at risk for school failure, the mechanisms through which SHCN impact on children's experiences (and therefore opportunities to intervene) at school are still relatively poorly understood. Based on the current literature, this paper provides a conceptual framework to guide further discussion of this issue in research, policy and practice. Evidence from the literature was reviewed and existing frameworks examined. We propose that SHCN impact on four interrelated domains of children's functioning: (1) body functions and structures; (2) activities of daily living; (3) social participation; and (4) educational participation. Children's functioning is further influenced by risk and protective factors that can be identified at the level of the child, family and service systems. Together, these processes contribute to shaping either positive or negative trajectories of school functioning. The mechanisms influencing school experiences for children with special health care needs are complex, with opportunities for positive interventions at a range of levels. The proposed conceptual model provides an accessible tool for guiding discussion of the support needs of this vulnerable population.

A survey on feasibility of ICF-CY use to describe persisting difficulties in executing tasks and activities of children and adolescent with disability in Italy

BACKGROUND

The criterion for the provision of disability benefits to people under 18 in Italy is the presence of persistent difficulties in carrying out the duties and functions of their own age; however, no national guidelines are available to support the Disability Commissions in assessing such difficulties.

OBJECTIVE

This study identified the different kinds of persisting difficulties in performing tasks and activities of children and adolescents with disability in Italy.

METHODS

We used a protocol based on a selection of 55 categories taken from the Activity and Participation components of the International Classification of Functioning, Disability and Health - Children and Youth version. Problems were represented dividing children by age groups, and categories were selected as relevant if reported by 20% of the cases as very severe/complete problems. A count-based methodology was chosen and categories were counted at the level of domain, showing differences related to age groups. Count-based complexity and severity indexes were calculated, reflecting the global amount of problems and the portion of very severe/complete ones.

RESULTS

Out of 415 children with disability enrolled in the study, 290 had persisting difficulties, with those referring to domestic life, major life areas and learning being the most common, and with specific age-related trends. The highest number of problems was reported for children in the 4-6 year age group.

CONCLUSIONS

Our approach is meant to foster a way toward understanding disability and functioning as a continuum, based on the amount and severity of difficulties that children may have, as opposed to a categorical, diagnosis-based approach.

Maternal supportive and interfering control as predictors of adaptive and social development in children with and without developmental delays

BACKGROUND

Parents of children with developmental delays (DD) have been found to use more controlling behaviour with their children than parents of children with typical development (TD). While controlling behaviour is related to poorer developmental outcomes in TD children, there is little research on how it predicts outcomes in DD children. Furthermore, existing research tends to use inconsistent or non-specific definitions of controlling behaviour, often combining parent control which follows the child's goal (e.g. supportive direction) and that which interferes with the child's goal (e.g. interference).

METHODS

Participants were 200 mother-child dyads observed at child age 3, with follow-up assessments of adaptive behaviour and social skills administered at child ages 5 and 6, respectively. We coded the frequency of both types of controlling behaviour based on mothers' interactions with their children with TD (n = 113) or DD (n = 87) at age 3.

RESULTS

Mothers in the DD group used more interfering but not more supportive directive acts compared to mothers in the TD group. Adaptive behaviour was assessed at child age 5 and social skills were assessed at age 6. Higher frequency of supportive directive acts predicted better adaptive functioning for the TD group and better social skills for the DD group. Higher frequency of interfering acts predicted lower adaptive and social skills for children with DD but not with TD.

CONCLUSIONS

Results are discussed in terms of the differential developmental needs of children with and without DD as well as implications for early intervention.