The relationship of loneliness and social anxiety with children’s and adolescents’ online communication

Children and adolescents now communicate online to form and/or maintain relationships with friends, family, and strangers. Relationships in “real life” are important for children’s and adolescents’ psychosocial development; however, they can be difficult for those who experience feelings of loneliness and/or social anxiety. The aim of this study was to investigate differences in usage of online communication patterns between children and adolescents with and without self-reported loneliness and social anxiety. Six hundred and twenty-six students aged between 10-16 years completed a survey on the amount of time they spent communicating online, the topics they discussed, the partners they engaged with, and their purposes for communicating over the Internet. Participants were administered a shortened version of the UCLA Loneliness Scale and an abbreviated sub-scale of the Social Anxiety Scale for Adolescents (SAS-A). Additionally, age and gender differences in usage of the aforementioned online communication patterns were examined across the entire sample. Findings revealed that children and adolescents who self-reported being lonely communicated online significantly more frequently about personal things and intimate topics than did those who did not self-report being lonely. The former were motivated to use online communication significantly more frequently to compensate for their weaker social skills to meet new people. Results suggest that Internet usage allows them to fulfill critical needs of social interactions, self-disclosure, and identity exploration. Future research, however, should explore whether or not the benefits derived from online communication may also facilitate lonely children’s and adolescents’ offline social relationships.

Children’s Views Matter Too! A Pilot Project Assessing Children’s and Adolescents’ Experiences of Clinical Psychology Services

This pilot study explored the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments. Fifteen young participants took part in the study. A content analysis indicated that young children and adolescents have an appropriate understanding of the role of the clinical psychologist, with older children commenting on the uniqueness and value of the therapeutic relationship. Attendance was rated as positive and helpful with regards to difficulties across all ages; however, many children were not consulted with at the point of referral and many did not know why they were attending. Implications for assessing children's and adolescents’ experiences of clinical psychology services are discussed.

Children's and adolescents' moral emotion attributions and judgments about exclusion of peers with hearing impairments

Children and adolescents with hearing impairments are at risk of being excluded from activities with hearing peers. Moral emotion attributions may represent important indicators for children’s identification with the moral norm not to exclude peers based on disability. Against this background, we investigated how 10-, 12- and 15-year-olds (N = 215) feel and judge about social exclusion of peers with hearing impairments. Emotion attributions and moral judgements were assessed using four different hypothetical scenarios about the exclusion of peers with hearing impairments (school vs. leisure time, group vs. dyad). Moreover, children’s and adolescents’ inclusive behaviour was assessed by a peer nomination procedure. Results revealed that moral emotion attributions differed as a function of exclusion context and grade. Moreover, participants with inclusive behaviour attributed moral emotions more often than participants with less inclusive behaviour. Implications of the results for moral education are discussed.

Canadian Society for Exercise Physiology Position Paper: Resistance Training in Children and Adolescents

Many position stands and review papers have refuted the myths associated with resistance training (RT) in children and adolescents. With proper training methods, RT for children and adolescents can be relatively safe and improve overall health. The objective of this position paper and review is to highlight research and provide recommendations in aspects of RT that have not been extensively reported in the pediatric literature. In addition to the well-documented increases in muscular strength and endurance, RT has been used to improve function in pediatric patients with cystic fibrosis, cerebral palsy and burn victims. Increases in children’s muscular strength have been attributed primarily to neurological adaptations due to the disproportionately higher increase in muscle strength than in muscle size. Although most studies using anthropometric measures have not shown significant muscle hypertrophy in children, more sensitive measures such as magnetic resonance imaging and ultrasound have suggested hypertrophy may occur. There is no minimum age for RT for children. However the training and instruction must be appropriate for children and adolescents involving a proper warm-up, cool-down and an appropriate choice of exercises. It is recommended that low-to-moderate intensity resistance should be utilized 2-3 times per week on non-consecutive days, with 1-2 sets initially, progressing to 4 sets of 8-15 repetitions for 8-12 exercises. These exercises can include more advanced movements such as Olympic style lifting, plyometrics and balance training, which can enhance strength, power, co-ordination and balance. However specific guidelines for these more advanced techniques need to be established for youth. In conclusion, a RT program that is within a child’s or adolescent’s capacity, involves gradual progression under qualified instruction and supervision with appropriately sized equipment can involve more advanced or intense RT exercises which can lead to functional (i.e. muscular strength, endurance, power, balance and co-ordination) and health benefits.

Participation in leisure and physical activity among children and adolescents with juvenile idiopathic arthritis

Contexte: L’arthrite juvénile idiopathique (AJI) est l’une des maladies chroniques auto-immune les plus répandues chez les enfants et est caractérisée par des enflures articulaires (maladie active), de la douleur, de la fatigue et des raideurs matinales pouvant restreindre leur niveau de participation aux activités quotidiennes (par exemple: les loisirs, l’activité physique, la mobilité et les soins personnels) à la maison comme à l’école. Participer aux activités de loisirs et à l’activité physique a des bienfaits au niveau de la santé et du développement de tous les enfants et démontrent aussi des effets positifs qui réduisent les symptômes des maladies chroniques telle l’AJI. Malgré ces bienfaits la participation aux loisirs chez les jeunes avec l’AJI demeure largement sous-étudiée. Objectifs: Cette étude vise à évaluer le niveau de participation aux loisirs et à l’activité physique chez les enfants et les adolescents atteints d’AJI, ainsi qu’à identifier les facteurs liés à la maladie, la personne et l’environnement. Méthodes : L’évaluation du niveau de participation et l’exploration des facteurs associés aux loisirs et à l’activité physique ont été complétés par l’entremise d’une revue systématique de la littérature, l’analyse de données d’un échantillon national représentatif d’enfants canadiens atteints d’arthrite âgés entre 5 et 14 ans (npondéré = 4350), ainsi que l’analyse standardisée du niveau de participation aux loisirs à l’aide du Children’s Assessment of Participation and Enjoyment (n=107) et la mesure objective de l’activité physique par accéléromètre (n=76) auprès d’un échantillon d’enfants (âgés entre 8 et 11 ans ) et d’adolescents (âgés entre 12 et 17 ans) suivis en clinique de rhumatologie à l’hôpital de Montréal pour enfants, Centre Universitaire de Santé McGill. Les résultats cliniques ont été comparés à des données normatives, ainsi qu’à un groupe contrôle sans AJI. Nous avons exploré les facteurs associés avec le niveau de participation aux loisirs et à l’activité physique en utilisant les modèles de régression linéaire multiple et l’analyse hiérarchique. Résultats : Les enfants et les adolescents atteints d’AJI participent à une multitude d’activités de loisirs; cependant ils sont moins souvent impliqués dans des activités physiques et de raffinement en comparaison aux autres types d’activités de loisirs. Ceux avec l’AJI étaient en général moins actifs que leurs pairs sans arthrite et la plupart n’atteignaient pas les recommandations nationales d’activité physique. Les garçons avec l’AJI participent plus souvent à des activités physiques et moins aux activités sociales, de raffinement et de développement de soi en comparaison avec les filles ayant l’AJI. En général, être un garçon, être plus âgé, avoir une meilleure motivation pour participer aux activités de motricité globale, avoir un statut socio-économique plus élevé et être d’origine culturelle canadienne sont associés à un niveau de participation plus élevé aux activités physiques. La préférence pour les activités de raffinement, un niveau d’éducation maternelle plus élevé et être une fille étaient associés à un niveau de participation plus élevé aux activités de raffinement. Conclusion: La participation aux loisirs et à l’activité physique en AJI est un concept complexe et semble surtout être expliqué par des facteurs personnels et environnementaux. L’identification des facteurs associés aux loisirs et à l’activité physique est très importante en AJI puisqu’elle peut permettre aux professionnels de la santé de développer des interventions significatives basées sur les activités préférées des enfants, améliorer l’observance au traitement et promouvoir des habitudes de vie saine.

Social participation and protagonism: Reflections fron the Conference of the Rights of Children’s and adolescent in Brazil

This paper examines the children and young people's participation and protagonism rights based on the Conferences on Children and Adolescents Rights' experience in Brazil, based on childhood sociology. Conferences' documents were consulted on the Brazilian government websites. These study findings revealed that young people's participation has increased in the last conferences. However, it is necessary to promote a systematic and genuine participation through democratic relations construction in all development contexts where childrenand adolescent live in order to modify their life and society participative practices.

Violence against children and adolescents: awareness and attitudes of Brazilian dentists

Violence against children and adolescents, ranging from negligence to sexual abuse, is an imperative public health problem. The ill treatments are considered as nonaccidental traumas, actions or omissions against children, who suffer physical or emotional violence. The main perpetrators are fathers, mothers, guardians, family, friends or the children‘s primary caretaker. It is very important to identify abuse cases, because this allows proper medical and legal intervention. In Brazil, the law n. 8.069, of July 13, 1990, known as the ECA -Statute for Children and Adolescents (SCA), stipulates the obligation to report suspected or confirmed cases of ill treatment against a child or adolescent to the Guardianship Council of the respective locality. The health professionals play a crucial role with regard to identifying cases of violence, collecting information, making early diagnosis of suspect cases and reporting such cases to the authorities. The dentists can contribute significantly, as most injuries occur in the orofacial region. Bite marks, burns, bruising, among others, are easily identified during a dental consultation. The aim of this work was to verify the awareness and attitudes of Brazilian dentists concerning violence against children and adolescents. This research was approved by the Research Ethics Committee of the Faculty of Dentistry of Araraquara – São Paulo State University (FOAr – UNESP). Sixty-three dentists answered an open and closed questionnaire concerning their formation, knowledge, experience and attitudes towards ill-treated children and adolescents. Among other results, thirty-nine dentists (61.9%) affirmed to have the means to identify illtreatment cases, 13 (20.6%) reported having some experience on this matter, but only 8 reported the cases to the Council of Guardianship, as determined by Brazilian law. Twenty percent of the reasons presented for not notifying the Council were fear of reprisal, and 60.0% were uncertain concerning the ethical and legal implications. Physical violence was the most reported form of identified violence (76.9%), followed by negligence (38.5%). Among the 13 professionals that had experience with violence cases, in 10 cases the perpetrators were identified – in 70.0% of the cases, the parents were the originators of such violence. It was concluded that further formation and orientation are necessary, in order to prepare dentists to act correctly when, during their professional activities, they encounter cases of violence against children and adolescents.

Quality-of-life in children and adolescents with cystic fibrosis managed in both regional outreach and cystic fibrosis center settings in Queensland

To assess the health-related quality-of-life (HRQOL) of children/adolescents with cystic fibrosis (CF) and compare HRQOL in children managed by cystic fibrosis outreach service (CFOS) with those treated in a cystic fibrosis center (CFC). To compare HRQOL of children with CF in Queensland with previously published HRQOL data from the United States and examine the relationship between HRQOL scores and pulmonary function. Study design: Participants were children/adolescents with CF and their parents managed by the Royal Children’s Hospital Queensland at a CFC or CFOS. Two HRQOL surveys were used: PedsQL™ and Cystic Fibrosis Questionnaire (CFQ). Results: There were 91 CFC and 71 CFOS participants with similar demographics. PedsQL™ total summary score was statistically higher in CFOS, P = .05. There was no significant difference in CFQ scores between groups. Queensland parents reported lower HRQOL for their children compared with US parents (P

NUTRITIONAL COUNSELING OFFERED TO CHILDREN AND ADOLESCENTS WITH DISABILITIES

Objective: To evaluate the nutritional counseling offered to children and adolescents with disabilities in the municipality of Santa Cruz, RN, Brazil. Methods: Observational, crosssectional, population-based study, developed from May to December 2013, with 102 children and adolescents attending a Children’s Rehabilitation Center. We conducted socioeconomic, demographic, health and lifestyle assessments, and evaluated the received nutritional assistance (whether they had received nutritional counseling from any health professional in relation to food and nutrition, how often it occurred and which professional conducted such counseling). Results: Only 37% (n=37) of parents had received some nutritional guidance. Regarding the frequency of counseling, only 11.8% (n=4) of the youngsters received it 7 or more times/year; 23.5% (n=8) received it 2 to 6 times/year; and most (64.7 %, n=22) received it 1 time/year or less. The length of the nutritional counseling was short: the majority (64.7%, n=22) received only one guidance session throughout the whole period attending the institution, and less than 15% (n=5) received counseling for more than six consecutive months. For the majority (73.5%, n=25), the amount of time receiving nutritional guidance has not reached half of the monitoring period. Nutritional counseling was carried out mainly by nutritionists (89.2%, n=33). Conclusion: There was a low frequency of nutritional counseling directed specifically to the disabilities presented by the participants. When such activity was conducted, it occurred irregularly during the participant´s follow-up, only during a short period of time, and lacking connection with the monitoring by the multidisciplinary team.

The relationship of loneliness and social anxiety with children's and adolescents' online communication

Children and adolescents are now using online communication to form and/or maintain relationships with strangers and/or friends. Relationships in real life are important for children and adolescents in identity formation and general development. However, social relationships can be difficult for those who experience feelings of loneliness and social anxiety. The current study aimed to replicate and extend research conducted by Valkenburg and Peter (2007b), by investigating differences in online communication patterns between children and adolescents with and without selfreported loneliness and social anxiety. Six hundred and twenty-six students aged 10-16 years completed a questionnaire survey about the amount of time they engaged in online communication, the topics they discussed, who they communicated with, and their purposes of online communication. Following Valkenburg and Peter (2007b), loneliness was measured with a shortened version of the UCLA Loneliness Scale (Version 3) developed by Russell (1996), whereas social anxiety was assessed with a sub-scale of the Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998). The sample was divided into four groups of children and adolescents: 220 were “non-socially anxious and non-lonely”, 139 were “socially anxious but not lonely”, 107 were “lonely but not socially anxious”, and 159 were “lonely and socially anxious”. A one-way ANOVA and chi-square tests were conducted to evaluate the aforementioned differences between these groups. The results indicated that children and adolescents who reported being lonely used online communication differently from those who did not report being lonely. Essentially, the former communicated online more frequently about personal things and intimate topics, but also to compensate for their weak social skills and to meet new people. Further analyses on gender differences within lonely children and adolescents revealed that boys and girls communicated online more frequently with different partners. It was concluded that for these vulnerable individuals online communication may fulfil needs of self-disclosure, identity exploration, and social interactions. However, future longitudinal studies combining a quantitative with a qualitative approach would better address the relationship between Internet use and psychosocial well-being. The findings also suggested the need for further exploration of how such troubled children and adolescents can use the Internet beneficially.

Health-related quality of life in obese children and adolescents

Objective: This review addresses the effect of overweight and obese weight status on pediatric health-related quality of life (HRQOL). Method: Web of Science, Medline, CINAHL, Cochrane Library, EMBASE, AMED and PubMed were searched for peer-reviewed studies in English reporting HRQOL and weight status in youth (<21 years), published before March 2008. Results: Twenty-eight articles were identified. Regression of HRQOL against body mass index (BMI) using pooled data from 13 studies utilizing the Pediatric Quality of Life Inventory identified an inverse relationship between BMI and pediatric HRQOL (r=−0.7, P=0.008), with impairments in physical and social functioning consistently reported. HRQOL seemed to improve with weight loss, but randomized controlled trials were few and lacked long-term follow-up. Conclusions: Little is known about the factors associated with reduced HRQOL among overweight or obese youth, although gender, age and obesity-related co-morbidities may play a role. Few studies have examined the differences in HRQOL between community and treatment-seeking samples. Pooled regressions suggest pediatric self-reported HRQOL can be predicted from parent proxy reports, although parents of obese youths tend to perceive worse HRQOL than children do about themselves. Thus, future research should include both pediatric and parent proxy perspectives.

The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents : implications for overweight and obesity

The obesity epidemic is a global trend and is of particular concern in children. Recent reports have highlighted the severity of obesity in children by suggesting: “today's generation of children will be the first for over a century for whom life expectancy falls.” This review assesses the evidence that identifies the important role of physical activity in the growth, development and physical health of young people, owing to its numerous physical and psychological health benefits. Key issues, such as “does a sedentary lifestyle automatically lead to obesity” and “are levels of physical activity in today's children less than physical activity levels in children from previous generations?”, are also discussed. Today's environment enforces an inactive lifestyle that is likely to contribute to a positive energy balance and childhood obesity. Whether a child or adolescent, the evidence is conclusive that physical activity is conducive to a healthy lifestyle and prevention of disease. Habitual physical activity established during the early years may provide the greatest likelihood of impact on mortality and longevity. It is evident that environmental factors need to change if physical activity strategies are to have a significant impact on increasing habitual physical activity levels in children and adolescents. There is also a need for more evidence-based physical activity guidelines for children of all ages. Efforts should be concentrated on facilitating an active lifestyle for children in an attempt to put a stop to the increasing prevalence of obese children