Parents' perceptions and concerns about their children's weight

Background: For parents to address overweight or obesity in their children, they first need to perceive their child to be overweight and to show some level of concern. We aimed to: (1) measure the level of misclassification between children’s actual and parent-perceived weight status, and (2) determine the level of parent concern about their child’s (actual) weight and whether concern varied according to the accuracy of parents’ perceptions.

Methods: Participants were 1711 primary school children aged 5–12 years from the Barwon-South West region of Victoria, Australia. Height and weight were measured and weight status determined using international standards. Parents completed a Computer Assisted Telephone Interview (CATI) that included questions relating to their child’s weight.

Results: 448 children (26.2% of sample) were overweight or obese. Of these, weight status for almost half (48%) was underestimated by parents. This ‘bias’ did not vary according to the child’s gender, parent’s education, or household socio-economic status but did for child’s age and parent-respondent gender. More than half (57%) of the parents of overweight-obese children expressed no concern about their child’s weight. Parents who underestimated the weight status of their overweight child were significantly less concerned (P < 0.001) about their child’s weight than those who correctly perceived their child as overweight.

Conclusions: Parents were relatively poor judges of overweight or obesity in their own child and consequently there was a lack of appropriately directed concern. Education to help parents correctly classify their child’s weight status should be part of efforts to prevent unhealthy weight gain.

Multi-type maltreatment : relationships between familial characteristics, maltreatment and adjustment of children and adults

This thesis examines the nature, extent and impact of multiple forms of maltreatment (multi-type maltreatment) from within a developmental victimological framework. The interrelationships between sexual abuse, physical abuse, psychological maltreatment, neglect, and witnessing family violence are assessed. The role of family variables in predicting maltreatment and the relative contribution of child maltreatment and family variables to adjustment are evaluated. Risk factors for multi-type maltreatment, and the relationship between multi-type maltreatment and adjustment are explored. The major theories of child development are reviewed. As well as exploring the relevance of developmental theories to understanding the impact of child maltreatment, factors influencing the emergence of child psychopathology are reviewed from a developmental psychopathology perspective. Ecological and developmental perspectives on how child maltreatment translates into the behavioural and emotional adjustment problems of children are integrated in the Child Maltreatment: Risk and Protection Model. After exploring some of the relevant conceptual issues, the literature on the prevalence and impact of each maltreatment type is reviewed, and the literature on multi-type maltreatment critiqued. Methodological and ethical concerns with the conduct of research in the field of child maltreatment using direct assessment of children led to the need for an instrument to assess parent perceptions of each of the types of abuse and neglect, as well as adult retrospective reports. Data are presented from two cross-sectional questionnaire-based studies using the Parent and Adult versions of the Family and Life Experiences Questionnaire which was designed to assess perceptions of children's experiences of sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence. Problems with the isolated focus of research on single forms of child maltreatment are addressed by the inclusion of each of these forms of child maltreatment within a single research design. Respondents for both studies were volunteers recruited from counselling agencies, medical, community health, child care and fitness centres and a first year psychology course. Parents (N=50) described their perceptions of primary school children's family characteristics, experiences of maltreatment and adjustment. Children's behavioural adjustment (internalising and externalising), sexual behaviours, emotions, self-esteem, gender identity, family adaptability and cohesion, parental traditionality, parental sexual punitiveness, interparental relationship satisfaction, and demographic characteristics are assessed in the study of Parents' perceptions. A large degree of overlap between the different types of abuse and neglect was found, with a high proportion of parents describing children's experiences of multiple forms of child maltreatment. Using both maltreatment and family characteristics to predict internalising behaviour problems, neglect and family cohesion were the only unique predictors. Family adaptability and cohesion were the only unique predictors of externalising behaviour problems. Physical and sexual abuse were not predicted from family characteristics; neglect was predicted, but no variables provided unique prediction. Unique predictors of psychological maltreatment were family cohesion, parental sexual punitiveness and divorce. Divorce was the only variable with significant unique prediction of the child witnessing family violence. Family background and family functioning were found to predict some forms of maltreatment, but to also be important factors mediating the adjustment of children, independent of maltreatment. The results are interpreted within an ecological framework, integrating risk factors for maltreatment with experiences of abuse and neglect and subsequent adjustment in childhood. Retrospective reports of adults' (N=175) own childhood family characteristics, experiences of maltreatment, and reports of their current adjustment are also studied. Included with the adult version of the FLEQ were the Trauma Symptom Checklist-40, Rosenberg's Self-esteem Scale, and the Family and Adaptability and Cohesion Evaluation Scale-II. Similar results were found in the in the Adult Study. As hypothesised, adult retrospective reports of the five different types of child maltreatment were found to be highly intercorrelated. Family characteristics predicted maltreatment and adjustment scores and discriminated between single and multi-type maltreatment. Maltreatment scores also predicted adult adjustment. As the number of maltreatment types increased, there was an increase in the number of adjustment problems reported. Alternate hypotheses regarding the possible operation of mediating and moderating processes in the relationships between family characteristics, maltreatment and the adjustment of adults were assessed. Finally, the results of these investigations are discussed and interpreted in the light of extant findings previously reviewed. Data from the two major empirical studies are used to demonstrate the overlap between different child maltreatment categories, and the extent and impact of multi-type maltreatment. The results show that children are vulnerable to more than one type of maltreatment. Individuals who experience a number of different forms of maltreatment had greater adjustment problems than those experiencing only one or two different types of abuse or neglect. Dysfunctional families place children at risk of child maltreatment. Negative family characteristics lead to adjustment problems in children and adults. The type of maltreatment having the most damaging effect on children was neglect, and in the long-term, sexual abuse. A multi-dimensional approach to prevention and intervention needs to be adopted, based on the co-morbidity of maltreatment types, and the likelihood of children experiencing further abuse or neglect of a different type. Dysfunctional family dynamics which place children at risk of multi-type maltreatment, and mediate the effects of maltreatment on adjustment, need to be specifically targeted with support and family intervention strategies. Risk-assessment measures used by Child Protection workers must include adequate knowledge of the inter-relationships between maltreatment types, and the particularly negative impact on adjustment of experiencing many forms of abuse or neglect. Suggestions for future clinical and research work in the area of child maltreatment are developed. The importance of assessing all forms of maltreatment when examining the relationships of maltreatment to adjustment is emphasised. It is recommended that prevention and intervention strategies acknowledge the interrelationships between maltreatment types.

Examination of the validity and usefulness of the video suggestibility scale for children

The Video Suggestibility Scale for Children (VSSC) was developed by Scullin and colleagues (Scullin & Ceci, 2000; Scullin & Hembrooke, 1998) as a tool for discriminating between children who have different levels of suggestibility. The scale requires children to view a 5-minute video about a birthday party, and to subsequently participate in an interview consisting of 18 yes/no questions. The VSSC consists of two main subscales; Yield (a measure of children's willingness to respond affirmatively to misleading questions about the video) and Shift (a measure of the children's tendency to change their responses after negative feedback from the interviewer). Preliminary research by Scullin and colleagues suggested that the scale possesses satisfactory internal consistency and that children's scores on the VSSC can predict their performance in another suggestibility paradigm. This thesis presents two studies, which further examine the validity and usefulness of the VSSC in an Australian sample of 3- to-5-year-old children. In Study One, children's performance on the VSSC (N = 77) was compared to their performance using other measures of suggestibility. These measures included children's willingness to assent to a false event as well as the number of false interviewer suggestions and new false details that the children provided in their accounts about an independent true-biased and an independent false (non-experienced) event. An independent samples t-test revealed that those children who assented to the false activity generated higher scores on the Yield measure. This pattern was also observed for the Shift subscale although it was not significant. Hierarchical regression analyses revealed that Yield was a significant predictor of the number of false details reported about the false activity, but not the true-biased activity. There was no significant relationship between the Shift Vlll subscale and any of the dependent variables. Overall this study provided partial support for the construct validity of the VSSC. However, it indicated that children's performance on this scale may not be generalisable across different contexts and interview paradigms, and that the Yield subscale is more generalisable than the Shift subscale. Study Two examined whether various group and individual factors that have previously been shown to relate suggestibility (i.e., age, IQ, memory, socio-economic status, gender, temperament) could predict suggestibility as measured by the VSSC. Two hundred and twenty children were recruited from kindergartens, and were divided into two broad socio-economic categories (based predominantly on income). Hierarchical regression analyses revealed that age, intelligence and memory inversely predicted children's Yield suggestibility. Further, children of low socio-economic backgrounds were more suggestible than children of high socio-economic background, and boys were more suggestible than girls on the Yield measure. Although shyness and other internalised and externalised characteristics were explored, no reliable significant relationships were found with Yield. With regard to the Shift subscale, no reliable relationships were found for any of the independent variables except for SES. Overall, results of Study 2 indicated that the VSSC is a potentially useful measure for discriminating between children's suggestibility on the basis on their individual characteristics, although benefits were observed mainly in relation to the Yield subscale. With reference to the findings of these two studies, the potential contribution of the VSSC for research and applied forensic contexts was discussed.

Case study of the integration of ICT's into the school curriculum

This study, conducted in a laptop environment, found many factors mediate teachers' integration of information and communication technologies (ICTs) into the curriculum. Successful integration of ICTs was not so much related to pedagogical style and teachers' self-sufficiency with computers, as to the principle of 'teachers first' and professional development which utilizes a 'situative-learning' model.

Developing mathematical concepts in Australian pre-school settings : the background

The SIMERR project Mathematical Thinking of Pre-school Children in Rural and Regional Australia: Research and Practice included a review of relevant research literature with the aim of making this accessible to researchers as well as early childhood teachers and educators. This paper introduces the methods used in the project and provides a brief summary of the literature pertaining to the development of mathematical concepts.

Children's physical activity levels during school recess : a quasi-experimental intervention study

Background : Recess provides a daily opportunity for children to engage in moderate-to-vigorous (MVPA) and vigorous physical activity (VPA). Limited research has investigated the effects of recess-based interventions on physical activity using large sample sizes whilst investigating variables that may influence the intervention effect. The aim of the study was to investigate the short-term effects of a playground markings and physical structures intervention on recess physical activity. A secondary aim was to investigate the effects of covariates on the intervention.

Methods : 150 boys and 147 girls were randomly selected from 26 elementary schools to wear uni-axial accelerometers that quantified physical activity every 5 seconds during recess. Fifteen schools located in deprived areas in one large urban city in England received funding through a national initiative to redesign the playground environment. Eleven schools served as matched socioeconomic controls. Data were collected at baseline and 6-weeks following playground intervention. Recess MVPA and VPA levels adjusted for pupil- and school-level covariates (baseline physical activity, age, gender, recess length, body mass index) were analysed using multilevel analyses.

Results : Positive but non-significant intervention effects were found for MVPA and VPA when confounding variables were added to the model. Gender was a significant predictor of recess physical activity, with boys engaging in more MVPA and VPA than girls. Significant interactions for MVPA revealed that the intervention effect was stronger for younger elementary aged school children compared to older children, and the intervention effect increased as daily recess duration increased.

Conclusion : The playground redesign intervention resulted in small but non-significant increases in children's recess physical activity when school and pupil level variables were added to the analyses. Changing the playground environment produced a stronger intervention effect for younger children, and longer daily recess duration enabled children to engage in more MVPA following the intervention. This study concludes that the process of increasing recess physical activity is complex when school and pupil-level covariates are considered, though they should be taken into account when investigating the effects of playground intervention studies on children's physical activity during recess.

Socio-economic and demographic variations in school lunch participation of French children aged 3-17 years

Objective: To assess school canteen attendance in a French nationally representative sample of children and to analyse its association with the socioeconomic and demographic characteristics of the children and their families.
Design: Data from the second French national cross-sectional food consumption survey (INCA2), performed in 2006–2007, were used. Information on usual weekly school canteen attendance was collected through a self-reported questionnaire, and demographic and socio-economic variables through a face-to-face questionnaire. The associations between school canteen attendance and the socio-economic and demographic variables were investigated by multivariate logistic regression analyses.
Setting: The INCA2 sample was representative of the children aged 3–17 years in France.
Subject: Analysis was performed on 1413 schoolchildren who completed the school canteen attendance questions.
Results: Some 65?6% of schoolchildren aged 3–17 years had school lunch at least once weekly. This rate of attendance was positively correlated with age. Whatever the school level, school canteen attendance was positively associated with the educational level of the caregiver/parent. In pre- and elementary-school children, enrolment at the school canteen was also higher when the caregiver/parent worked, or in single-parent families. In secondary-school children, school lunch participation decreased with children living in more densely populated areas and increased with the level of the household’s living standards.
Conclusions: School canteen attendance was positively associated with children’s socio-economic background. This could reduce the effectiveness of the forthcoming school meal composition regulations designed to improve the diet of children from deprived backgrounds, who are more likely to have unhealthy food habits.

The subjective wellbeing of high-school students : validating the personal wellbeing index—school children

The Personal Wellbeing Index—School Children (PWI-SC) is designed as a parallel form of the adult PWI-A, to measure subjective wellbeing. This study examines the psychometric properties of the PWI-SC. Data from 351 students, aged between 12 and 20 years, were collected by two independent studies over the years 2005–2006. Using the combined data, the results indicate good psychometric properties for the PWI-SC. It is also found that females have higher SWB but that both genders show an age-related decline in SWB from early to mid adolescence. Notably, School satisfaction meets the criteria for a new domain for the PWI-SC and should be considered for inclusion in a future revision of the scale. The use of the PWI-SC in schools can provide important information for the development of educational policy.

Obesity prevention in the family day care setting : impact of the romp & chomp intervention on opportunities for children's physical activity and healthy eating

Background The Romp & Chomp intervention reduced the prevalence of overweight/obesity in pre-school children in Geelong, Victoria, Australia through an intervention promoting healthy eating and active play in early childhood settings. This study aims to determine if the intervention successfully created more health promoting family day care (FDC) environments.
Methods The evaluation had a cross-sectional, quasi-experimental design with the intervention FDC service in Geelong and a comparison sample from 17 FDC services across Victoria. A 45-item questionnaire capturing nutrition- and physical activity-related aspects of the policy, socio-cultural and physical environments of the FDC service was completed by FDC care providers (in 2008) in the intervention (n = 28) and comparison (n = 223) samples.
Results Select results showed intervention children spent less time in screen-based activities (P = 0.03), organized active play (P < 0.001) and free inside play (P = 0.03) than comparison children. There were more rules related to healthy eating (P < 0.001), more care provider practices that supported children’s positive meal experiences (P < 0.001), fewer unhealthy food items allowed (P = 0.05), higher odds of staff being trained in nutrition (P = 0.04) and physical activity (P < 0.001), lower odds of having set minimum times for outside (P < 0.001) and organized (P = 0.01) active play, and of rewarding children with food (P < 0.001).
Conclusions Romp & Chomp improved the FDC service to one that discourages sedentary behaviours and promotes opportunities for children to eat nutritious foods. Ongoing investment to increase children’s physical activity within the setting and improving the capacity and health literacy of care providers is required to extend and sustain the improvements.

Do children's food preferences align with dietary recommendations?

Objectives: To examine how Australian children's reported everyday food preferences reflect dietary recommendations, and the impact of sociodemographic factors on these associations.

Design:  Cross-sectional survey.

Setting/subjects: Three hundred and seventy-one parents of children aged 2–5 years, recruited from three socio-economic groups in two Australian cities, completed a survey on their child's liking for 176 foods and drinks on a 5-point Likert scale in addition to demographic descriptors. Preferences were compared with the recommendations of the Dietary Guidelines for Children and Adolescents in Australia and the Australian Guide to Healthy Eating.

Results:  Foods in the Extra Foods (non-nutritious foods) and Cereals groups of the Australian Guide to Healthy Eating were highly liked (mean: 4.02 and 4.01, respectively), whilst foods in the Vegetables group were liked least (mean: 3.01). A large percentage of foods in the Cereals and Extra Foods groups were liked (64% and 56%, respectively) in contrast to the other food groups, especially Vegetables (7%). Children liked foods that were higher in sugar (r = 0.29, P < 0.0001) and more energy-dense (r = 0.34, P < 0.0001) but not those higher in saturated fat (r = 0.16, P = 0.03), total fat (r = 0.12, P = 0.12) or sodium (r = 0.10, P = 0.18). Sociodemographic variables (e.g. socio-economic status, parental education, children's age and sex) explained little of the variation in children's food preferences.

Conclusions:  Australian pre-school children's food preferences align with dietary guidelines in some respects, but not others. Interventions are needed to shift children's preferences away from non-nutritious foods that are high in energy density and sugar, and towards vegetables and fruits.

A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3-5 year old children

Objective : To examine the potential efficacy of a brief telephone-based parental intervention in increasing fruit and vegetable consumption in children aged 3–5 years and to examine the feasibility of intervention delivery and acceptability to parents.

Design : A pre–post study design with no comparison group. Telephone surveys were conducted approximately 1 week before and following intervention delivery.
Setting Participants were recruited through pre-schools in the Hunter region, New South Wales, Australia.

Subjects : Thirty-four parents of 3–5-year-olds received four 30-min interventional telephone calls over 4 weeks administered by trained telephone interviewers. The scripted support calls focused on fruit and vegetable availability and accessibility within the home, parental role modelling of fruit and vegetable consumption and on implementing supportive family eating routines.

Results : Following the intervention, the frequency and variety of fruit and vegetable consumption increased (P = 0·027), as measured by a subscale of the children's dietary questionnaire. The intervention was feasible to be delivered to parents, as all participants who started the intervention completed all four calls, and all aspects of the interventional calls, including the number, length, content, format and relevance, were considered acceptable by more than 90 % of parents.

Conclusions : A brief telephone-based parental intervention to encourage fruit and vegetable consumption in pre-school-aged children may be effective, feasible and acceptable. Further investigation is warranted in a randomised controlled trial.

Are children's perceptions of neighbourhood social environments associated with their walking and physical activity?

This study aimed to examine cross-sectional associations between neighbourhood social environmental factors and physical activity (PA) among Australian primary school children. Baseline data from a large-scale trial among 957 children (48% boys) aged 9–12 years were utilised. Children self-reported their perceptions of the neighbourhood social environment including social networks (e.g. there are lots of other children around to play with), and social capital (e.g. there are lots of people in my area I could go to if I need help). Children also self-reported their weekly walking frequency and PA from which average daily moderate to vigorous PA (MVPA) was calculated. Linear regression analyses examined these associations. Boys performed 17 min/day more MVPA than girls (p < 0.01), and girls performed one extra trip/week than boys (p < 0.001). Children’s perceptions of social capital (p < 0.0001) and social networks (p < 0.01) were both positively associated with MVPA and social capital was positively associated with walking frequency (p < 0.05). These associations were not moderated by the child’s sex. These findings suggest that children who had positive perceptions of neighbourhood social capital and social networks in the neighbourhood, tended to be more physically active. Longitudinal and experimental studies are required to further test the influence of these factors among children.

Children and university architecture students working together : a pedagogical model of children’s participation in architectural design

Increasing efforts have been made to engage children in the design of the built environment, and several participatory models have been developed. The aim of this paper is to propose a pedagogical model for children's genuine participation in architectural design, developed in an architectural education context. According to this pedagogical model, children (primary school students) and youth (university architecture students) work in teams to develop the architectural design proposals. This model was developed through a joint educational project between Deakin University and Wales Street Primary School (both institutions are based in Victoria, Australia). In the four-week duration of the project, first year architecture students worked with Grade 3 and 4 primary school children to design a school playground. The final product of the project was a 1:20 scale model of a playground, which was installed and presented at the end of the fourth week. The project received positive feedback from all the participants, including children, architecture students, university lecturers, primary school teachers and architects. In addition, it achieved a high level of children's genuine participation. This model can be refined and applied in new situations, and potentially with other primary schools working with Deakin University.

Conducting field research in a primary school setting : methodological considerations for maximizing response rates, data quality and quantity

Background: Schools are an ideal setting in which to involve children in research. Yet for investigators wishing to work in these settings, there are few method papers providing insights into working efficiently in this setting.

Objective: The aim of this paper is to describe the five strategies used to increase response rates, data quality and quantity in the TRansport Environment and Kids (TREK) project.

Setting: The TREK project examined the association between neighbourhood urban design and active transport in Grade 5–7 school children (n = 1480) attending 25 primary schools in metropolitan Perth, Western Australia during 2007.

Method: Children completed several survey components during school time (i.e. questionnaire, mapping activity, travel diary and anthropometric measurements) and at home (i.e. pedometer study, parent questionnaire).

Results: Overall, 69.4% of schools and 56.6% of children agreed to participate in the study and, of these, 89.9% returned a completed travel diary, 97.8% returned their pedometer and 88.8% of parents returned their questionnaire. These return rates are superior to similar studies. Five strategies appeared important: (1) building positive relationships with key school personnel; (2) child-centred approaches to survey development; (3) comprehensive classroom management techniques to standardize and optimize group sessions; (4) extensive follow-up procedures for collecting survey items; and (5) a specially designed data management/monitoring system.

Conclusion: Sharing methodological approaches for obtaining high-quality data will ensure research opportunities within schools are maximized. These methodological issues have implications for planning, budgeting and implementing future research.

Associations between usual school lunch attendance and eating habits and sedentary behaviour in French children and adolescents

Background/Objective: Our objective was to investigate whether school lunch attendance was associated with overall eating habits and sedentary behaviour in a French sample of children and adolescents.

Subjects/Methods: Data for the study were taken from the second French cross-sectional dietary survey (INCA2-2006-07). In total, 1413 school children aged 3–17 years old were classified according to their school type and their usual school lunch attendance. Eating habits included meal regularity, dietary diversity, purchase in vending machine, snacking habits and frequency of eating in fast-foods. Two composite indices of eating habits were derived from multiple correspondence analyses. Sedentary behaviour was assessed by the average daily screen times for TV and computer. The association between school lunch attendance and each variable was tested. Multivariate association between school lunch attendance and the composite indices of eating habits and sedentary behaviours was studied.

Results: In all, 69.0% (CI95%: 64.2–73.9) of secondary school children and 63.0% (CI95%: 58.5–67.5) of pre- and elementary school children usually attended school lunch at least once a week. Pre- and elementary school children attending school lunches showed a higher dietary diversity score (P=0.02) and ate morning snacks more frequently (P=0.02). In secondary school children, attending school canteen was related to a lower rate of skipping breakfast (P=0.04) and main meals (P=0.01). In all school children, school lunch attendance was simultaneously associated with healthier overall eating habits and less sedentary behaviour.

Conclusion: In France, children attending school canteens seem to have healthier eating habits and display less sedentary behaviour, independently of their socio-economic and demographic background.