The effectiveness of splinting as perceived by the parents of children with Juvenile Ideopathic Arthritis

Juvenile idiopathic arthritis (JIA) is an important disease of childhood with farreaching effects on the child and family. Splinting is a major treatment modality used by occupational therapists for children with JIA. Parents play a central role in whether, when and how splints are used with their children on a daily basis. This paper describes a qualitative research project, which was undertaken to evaluate an occupational therapy service for children with JIA whose treatment had involved splinting. Using semi-structured interviews, the study investigated five mothers' perceptions of the effectiveness of splinting for their children. The interviews revealed five major points. First, the informants generally believed the splinting to be effective. Secondly, the children involved generally resisted wearing splints because they were physically uncomfortable and made them feel different to other children. Thirdly, the mothers used a variety of strategies to ensure that their children wore the splints. Fourthly, the perception of having a positive and supportive relationship with the therapist enhanced the mothers' ability to adhere to splinting. Lastly, the mothers' grief at having a child with JIA influenced their ability to understand and attend to information about specific interventions such as splinting. Practical responses to these findings are outlined.

The association between auditory memory span and speech rate in children from kindergarten to sixth grade

This study reexamined the association between speech rate and memory span in children from kindergarten to sixth grade (N = 152) in order to potentially account for the inconsistencies within the published literature on this topic. Some of the inconsistencies in past research may reflect the different methods adopted in assessing speech rate. In particular, repeating word triples may itself involve memory demands, contaminating the correlation between speech rate and memory span in younger children. Analyses using composite speech rate and memory span measures showed that speech rate for word triples shared variance with memory span that was independent of speech rate for single words. Moreover, speech rate for word triples was largely redundant with age in explaining additional variation in memory span once the effects of speech rate for single words were controlled. (C) 2002 Elsevier Science.

Segmentation of spoken words into syllables by English-speaking children as compared to adults

Given the importance of syllables in the development of reading, spelling, and phonological awareness, information is needed about how children syllabify spoken words. To what extent is syllabification affected by knowledge of spelling, to what extent by phonology, and which phonological factors are influential? In Experiment 1, six- and seven-year-old children did not show effects of spelling on oral syllabification, performing similarly on words such as habit and rabbit. Spelling influenced the syllabification of older children and adults, with the results suggesting that knowledge of spelling must be well entrenched before it begins to affect oral syllabification. Experiment 2 revealed influences of phonological factors on syllabification that were similar across age groups. Young children, like older children and adults, showed differences between words with short and long vowels (e.g., lemon vs. demon) and words with sonorant and obstruent intervocalic consonants (e.g., melon vs. wagon). (C) 2002 Elsevier Science (USA). All rights reserved.

Theory of mind and peer acceptance in preschool children

Two studies tested the hypothesis that preschool children's theory of mind ability is related to their levels of peer acceptance. In Study 1, 78 children between the ages of 4 and 6 provided peer nominations that allowed determination of social preference and social impact scores, and classification in one of five peer status groups (following Coie & Dodge, 1983). Children were also tested on five different theory of mind tasks. The results showed that theory of mind scores were significantly related to social preference scores in a subsample of children who were over 5 years old. Further, popular children were found to score higher on theory of mind tasks than children classified as rejected. Study 2 replicated and extended the first study with a new sample of 87 4- to 6-year-old children. Study 2 included measures of peer acceptance, theory of mind ability and verbal intelligence, as well as teacher ratings of prosocial and aggressive behaviours. The results of Study 2 showed that for the total group of children, prosocial behaviour was the best predictor of social preference scores. When the Study 2 sample was split into older and younger children, theory of mind ability was found to be the best predictor of social preference scores for the older children (over age 5), while aggressive and prosocial behaviours were the best predictors of peer acceptance in the younger children. Overall, the pattern of results suggests that the impact of theory of mind ability on peer acceptance is modest but increases with children's age.

Environmental conditions and variation in levels of sun exposure among children in child care

Sun exposure in childhood is I of the risk factors for developing skin cancer, yet little is known about levels of exposure at this age. This is particularly important in countries with high levels of ultraviolet radiation. (UVR) such as Australia. Among 49 children 3 to 5 years of age attending child care centers, UVR exposure was studied under 4 conditions in a repeated measures design; sunny days, cloudy days, teacher's instruction to stay in the shade, and a health professionals instruction to apply sunscreen. Three different data collection methods were employed: (a) completion of questionnaire or diary by parents and researcher, (b) polysulphone dosimeter readings, and (c) observational audits (video recording). Results of this study indicated that more than half the children had been sunburnt (pink or red) and more than a third had experienced painful sunburn (sore or tender) in the last summer. Most wore short sleeve shirts, short skirts or shorts and cap, that do not provide optimal levels of skin protection. However, sunscreen was applied to all exposed parts before the children went out to the playground. Over the period of I hr (9-10 a.m.) the average amount of time children spent in full sun was 22 min. On sunny days there was more variation across children in the amount of sun exposure received. While the potential amount of UVR exposure for young children during the hour they were outside on a sunny day was 1.45 MED (Minimum Erythemal Dose), they received on average 0.35 MED, which is an insufficient amount to result in an erythemal response on fair skin even without the use of sunscreen.

Opening windows into the mind: mothers' preferences for mental state explanations and children's theory of mind

A new questionnaire, the Maternal Mental State Input Inventory (MMSII) was created to measure mothers' preferences for introducing and elaborating on mental states in conversation with their young children. In two studies, the questionnaire was given to mothers of young children, and the children's theory of mind (ToM) development was assessed with standard tasks. In both studies, the questionnaire exhibited good internal reliability, and significant correlations emerged between mothers' self-reported preferences for elaborated, explanatory talk about the mental states and children's theory of mind performance. Further, mothers' conversational preferences, as measured by the MMSII, were the best predictors of children's theory of mind development when relevant control variables were included in the analyses. These results converge with naturalistic observational research that has demonstrated links between mothers' conversational styles and their children's theory of mind. They go further in suggesting that mothers' tendencies toward elaborated, explanatory talk about a range of mental states is particularly beneficial to children's theory of mind development. (C) 2003 Elsevier Inc. All rights reserved.

The application of cognitive orientation to daily occupational performance (CO-OP) with children 5-7 years with developmental coordination disorder

There has been an increase in the use of cognitive frameworks in occupational therapy with children with developmental coordination disorder (DCD). Investigations into the utility of one such cognitive approach, namely Cognitive Orientation to (daily) Occupational Performance (CO-OP), with children with DCD have shown the intervention to be effective with children over 7 years. However, there has been limited research into its utility with younger children. This paper presents two case studies to demonstrate the use of CO-OP with children aged 5-7 years. Two boys with DCD engaged in 10 sessions of CO-OP. These younger children were found to be able to use the global framework (Goal, Plan, Do, Check) to improve their task performance, to develop plans using domain-specific strategies and to engage in checking strategies. Issues relating to attention, motivation and goal setting are discussed in the context of the two case studies.

Socioeconomic position, cognitive function, and clustering of cardiovascular risk factors in adolescence: Findings from the Mater University Study of Pregnancy and its outcomes

Objectives: The objectives of this study were to examine the extent of clustering of smoking, high levels of television watching, overweight, and high blood pressure among adolescents and whether this clustering varies by socioeconomic position and Cognitive function. Methods: This study was a cross-sectional analysis of 3613 (1742 females) participants of an Australian birth cohort who were examined at age 14. Results: Three hundred fifty-three (9.8%) of the participants had co-occurrence of three or four risk factors. Risk factors clustered in these adolescents with a greater number of participants than would be predicted by assumptions of independence having no risk factors and three or four risk factors. The extent of clustering tended to be greater in those from lower-income families and among those with lower cognitive function. The age-adjusted ratio of observed to expected cooccurrence of three or four risk factors was 2.70 (95% confidence interval [Cl], 1.80-4.06) among those from low-income families and 1.70 (95% Cl, 1.34-2.16) among those from more affluent families. The ratio among those with low Raven's scores (nonverbal reasoning) was 2.36 (95% Cl, 1.69-3.30) and among those with higher scores was 1.51 (95% Cl, 1.19-1.92); similar results for the WRAT 3 score (reading ability) were 2.69 (95% Cl, 1.85-3.94) and 1.68 (95% Cl, 1.34-2.11). Clustering did not differ by sex. Conclusion: Among adolescents, coronary heart disease risk factors cluster, and there is some evidence that this clustering is greater among those from families with low income and those who have lower cognitive function.

Common causes of sleep disruption and daytime sleepiness: childhood sleep disorders II

There are strong associations between childhood sleep disorders and behavioural, concentration and mood problems. Sleep disorders caused and maintained by behavioural factors (eg, sleep-onset association disorder) are common in young children, and have a significant impact on families. Evaluation should include a medical history, a physical, neurological and developmental examination, a description of any nocturnal events or daytime effects of the child's disturbed sleep, and a good understanding of the family situation and parental management of the child. Management involves recognising the developmental age of the child and the family dynamics, and educating and supporting families in applying behavioural techniques to establish good sleep hygiene. Children with parasomnias (eg, night terrors) also benefit from good sleep hygiene, while those with respiratory or neurological causes of sleep disturbance should be referred for specialist treatment.

Effectiveness of a mutual support group for families of patients with schizophrenia

Aim. This paper reports a study to examine the effectiveness of a 12-session mutual support group for Chinese families caring for a relative with schizophrenia compared with a psycho-educational group and routine family support services in Hong Kong. Background. Schizophrenia is a disruptive and distressing illness for patients and their families. With the current trend of community care for mental illness, there is evidence that family intervention reduces patient relapse and re-hospitalization, satisfies the health needs of families and enhances their coping capabilities. Methods. A randomized controlled trial was conducted from May 2002 to June 2003 with 96 Chinese families of a relative with schizophrenia selected from two psychiatric outpatient clinics in Hong Kong. Families were randomly assigned to receive mutual support (n = 32), psycho-education (n = 33) or standard care only (n = 31). The interventions were delivered at outpatient clinics over a 6-month period. Pre- and post- (1 week and 6 months) testing took place and families' functioning, mental health service utilization, patients' level of functioning and duration of re-hospitalization were measured. Results. At both post-test periods, family caregivers and patients in the mutual support group reported statistically significant improvements on family and patients' level of functioning, when compared with their counterparts in the psycho-education and standard care groups. Conclusions. The findings support the use of mutual support groups as an effective modality of family intervention in a Chinese population caring for a family member with schizophrenia to improve both family and patient functioning.

Why children and adults sometimes (but not always) compute implicatures

Noveck (2001) argued that children even as old as 11 do not reliably endorse a scalar interpretation of weak scalar terms (some, might, or) (cf. Braine & Rumain, 1981; Smith, 1980). More recent studies suggest, however, that children's apparent failures may depend on the experimental demands (Papafragou & Musolino, 2003). Although previous studies involved children of different ages as well as different tasks, and are thus not directly comparable, nevertheless a common finding is that children do not seem to derive scalar implicatures to the same extent as adults do. The present article describes a series of experiments that were conducted with Italian speaking subjects (children and adults), focusing mainly on the scalar term some. Our goal was to carefully examine the specific conditions that allow the computation of implicatures by children. In so doing, we demonstrate that children as young as 7 (the youngest age of the children who participated in the Noveck study) are able to compute implicatures in experimental conditions that properly satisfy certain contextual prerequisites for deriving such implicatures. We also present further results that have general consequences for the research methodology employed in this area of study. Our research indicates that certain tasks mask children's understanding of scalar terms, not only including the task used by Noveck, but also tasks that employ certain explicit instructions, such as the training task used by Papafragou & Musolino (2003). Our findings indicate further that, although explicit training apparently improves children's ability to draw implicatures, children nevertheless fail to achieve adult levels of performance for most scalar terms even in such tasks, and that the effects of instruction do not last beyond the training session itself for most children. Another relevant finding of the present study is that some of the manipulations of the experimental context have an effect on all subjects, whereas others produce effects on just a subset of children. Individual differences of this kind may have been concealed in previous research because performance by individual subjects was not reported. Our general conclusions are that even young children (7-year olds) have the prerequisites for deriving scalar implicatures, although these abilities are revealed only when the conversational background is natural.

Do chimpanzees (Pan troglodytes) and 2-year-old children (Homo sapiens) understand double invisible displacement?

Chimpanzees (Pan troglodytes) and young children (Homo sapiens) have difficulty with double invisible displacements in which an object is hidden in two nonadjacent boxes in a linear array. Experiment 1 eliminated the possibility that chimpanzees' previous poor performance was due to the hiding direction of the displacement device. As in Call (2001), subjects failed double nonadjacent displacements, showing a tendency to select adjacent boxes. In Experiments 2 and 3, chimpanzees and 24-month-old children were tested on a new adaptation of the task in which four hiding boxes were presented in a diamond-shaped array on a vertical plane. Both species performed above chance on double invisible displacements using this format, suggesting that previous poor performance was due to a response bias or inhibition problem rather than a fundamental limitation in representational capacity.

Testing the protracted lexical restructuring hypothesis: The effects of position and acoustic-phonetic clarity on sensitivity to mispronunciations in children and adults

Although developmental increases in the size of the position effect within a mispronunciation detection task have been interpreted as consistent with a view of the lexical restructuring process as protracted, the position effect itself might not be reliable. The current research examined the effects of position and clarity of acoustic-phonetic information on sensitivity to mispronounced onsets in 5- and 6-year-olds and adults. Both children and adults showed a position effect only when mispronunciations also differed in the amount of relevant acoustic-phonetic information. Adults' sensitivity to mispronounced second-syllable onsets also reflected the availability of acoustic-phonetic information. The implications of these findings are discussed in relation to the lexical restructuring hypothesis. (c) 2006 Elsevier Inc. All rights reserved.

Toddler subtraction with large sets: further evidence for an analog-magnitude representation of number

Two experiments were conducted to test the hypothesis that toddlers have access to an analog-magnitude number representation that supports numerical reasoning about relatively large numbers. Three-year-olds were presented with subtraction problems in which initial set size and proportions subtracted were systematically varied. Two sets of cookies were presented and then covered The experimenter visibly subtracted cookies from the hidden sets, and the children were asked to choose which of the resulting sets had more. In Experiment 1, performance was above chance when high proportions of objects (3 versus 6) were subtracted from large sets (of 9) and for the subset of older participants (older than 3 years, 5 months; n = 15), performance was also above chance when high proportions (10 versus 20) were subtracted from the very large sets (of 30). In Experiment 2, which was conducted exclusively with older 3-year-olds and incorporated an important methodological control, the pattern of results for the subtraction tasks was replicated In both experiments, success on the tasks was not related to counting ability. The results of these experiments support the hypothesis that young children have access to an analog-magnitude system for representing large approximate quantities, as performance on these subtraction tasks showed a Webers Law signature, and was independent of conventional number knowledge.

Towards a public health approach to parenting

There are various parenting, school and personal factors at play in determining a child’s risk of developing serious conduct problems. The temptation is therefore to conclude that “more is better than less”, but we think that has not been convincingly demonstrated. Some large-scale multi-risk-factor reduction approaches that include parenting, school and child-specific interventions with older school-aged children have shown promise but are complex to administer, costly to implement and have yet to show strong long-term outcomes. But in young children (toddler and preschool-aged children) there is strong evidence that social-learning-based parenting programmes are effective with a wide range of families from quite diverse socio-economic and ethnic backgrounds. We choose to focus on such programmes.