Children's Access Research Articles

The Effect of Semantic Context on Lexical Access in Children With and Without Developmental Language Disorder

Objectives: Lexical access problems are one of the limitations observed in children with developmental language disorders during the initial years of schooling. Semantic context has a powerful influence on lexical access. The cross-modal visual-auditory picture-word interference paradigm is a method for studying adults and children's lexical access. Because few studies have examined lexical access in Persian-speaking children, the present study aimed to investigate the effect of different semantic contexts on lexical access in children with and without developmental language disorder. Methods: In this experimental study, 20 children aged 7-9 years with developmental language disorders and 20 age-matched peers were recruited according to the inclusion and exclusion criteria. At first, the picture-word interference paradigm was prepared. In so doing, 16 common pictures of objects paired with four auditory interfering words (related verb, related noun, unrelated verb, and unrelated noun) were presented to the children in a silent condition to determine their naming accuracy and latency. The DMDX software calculated the naming latency. The percentage of correct names also calculated naming accuracy. Results: Naming latencies were significantly faster in children without language disorders (P≤0.05). In addition, a reliable interference effect was found. According to the results, naming latencies were significantly faster for related verb distractors than unrelated verbs and related noun distractors (P<0.05). In addition, a significant difference was observed between the silent and interference conditions regarding the naming accuracy. However, accuracy was not affected by distractors. Discussion: Different semantic contexts affect lexical access differently in children. These differences cause semantic relatedness between verbs and nouns in lexical networks. The present study findings indicate that lexical knowledge and semantic relatedness are lower in children with developmental language disorders than in those with typical language development. These results can be useful for future studies and interventions on lexical access in children with and without language disorders.

Caregiver-reported impact of access to switch-adapted toys on play for children with complex medical conditions.

Play is essential for children's development of motor, social-emotional and cognitive skills. Traditional play activities are often difficult for children with complex medical conditions to access, which threatens their ability to maximize their developmental potential. Switch-adapted toys are a common strategy for expanding the play repertoire of children with disabilities by lowering the barrier to play with electronic toys. The aim of this study is to investigate the relationship between providing switch-adapted toys to children with disabilities and the children's total and self-initiated play time and access to a variety of cognition-appropriate toys, age-appropriate toys and independently accessible toys as reported by their caregivers. Caregivers and their children with complex medical conditions were provided switch-adapted toys at a giveaway event. At the giveaway event and 6 months later, caregivers completed a survey that included questions about each child's current participation in play and their type of play, child's access to toys and questions specific to switches and switch-adapted toys. Data were analysed using Wilcoxon signed-rank tests with a Benjamini-Hochberg procedure to control for multiple comparisons. Nineteen caregivers completed both the pre- and post-surveys. The increases in the variety of toys and the number of independently accessibly and cognitively appropriate toys were statistically significant. The change in number of age-appropriate toys and the amount of total and active play time were not statistically significant. Providing switch-adapted toys may be an effective way to increase the number of independently accessible and cognitively appropriate toys for children with complex medical conditions. However, increasing the number of such toys may not be sufficient to increase active and total play time. Further research is needed to identify variables impacting play time and distal outcomes associated with switch-adapted toy access.

Contextual antecedents and well-being indicators associated with children's and adolescents' access to supportive nonparent adults.

The aim of this study was to examine contextual antecedents and well-being indicators associated with children's and adolescents' access to supportive nonparent adults (SNPAs). We conducted secondary data analysis of the 2016 National Survey of Children's Health, a large-scale caregiver-reported survey. We analyzed separate subsamples of children (ages 6-11, n = 12,849) and adolescents (ages 12-17, n = 17,628). For both children and adolescents, markers of social advantage (e.g., White race, nonimmigrant families, neighborhood/community capital, access to extracurriculars) increased the likelihood of having SNPAs, according to parent or caregiver reports. Familial factors (e.g., parent participation in school and extracurricular activities) were stronger predictors of SNPA presence for children. Access to SNPAs was negatively associated with social difficulties among children and adolescents and positively associated with curiosity and overall health among adolescents. In conclusion, disadvantage across multiple ecological levels impairs children's and adolescents' access to SNPAs. Having an SNPA may be associated with some aspects of youth well-being, although causality cannot be inferred in cross-sectional data.

The expanding role of the curator ad litem i n protecting children's rights in South Africa

The appointment of the curator ad litem during litigation in which children's interests are concerned has, over the years, played a critical role in advancing the child's right to be heard and participate in matters affecting them for the advancement of their best interests. Prof Boezaart's seminal article on the role of the curator ad litem and children's access to the courts set out a comprehensive review of the origins, duties and role of the curator. Litigation and resultant court pronouncements subsequent to the article have continued to affirm the importance of the curator's role in matters dealing with the care of children; delictual matters in which children have legitimate financial claims; and acquisition of parental rights and responsibilities of the unborn child. The courts have affirmed the fact that the curator must only be appointed when their presence is necessary and not duplicate the functions of attorneys representing parents or caregivers of the children or the parents or caregivers themselves. The curator represents and protects the interests of the children concerned, prevents conflict with the interests of the parents, guardian or caregiver or represents the child when such parent, guardian or caregiver is unwilling to act in the interests of the child. The courts have held that in highly contested matters, the curator must, as an officer of the court, keep an open mind, remain neutral, and be open to all arguments in the interests of the children concerned. They must not allow themselves to be distracted by contentious issues in litigation and must honour their obligation to provide insight into the wishes and views of children and to apply their legal knowledge to the child's perspective. The curator has also played a critical role in protecting the interest of the unborn child by conducting an objective investigation and ensuring that their interests are fully before the court.

Effectiveness of a school-based, lay counselor-delivered cognitive behavioral therapy for Chinese children with posttraumatic stress symptoms: a randomized controlled trial

Improving children's access to mental health services need more innovative solutions, especially in low- and middle-income countries. School-based psychosocial interventions delivered by lay counselors may be an efficient way to improve children's access to mental health services. But few studies were conducted to examine the effectiveness of these interventions. Therefore, this study is to evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) in a group format delivered by lay counselors to children with trauma-related symptoms in China. A total of 234 children (aged 9-12 years) with full or subthreshold posttraumatic stress disorder (PTSD) were randomly assigned to group-based TF-CBT or treatment as usual (TAU). In the intervention group, 118 children received 10-12 sessions of group-based TF-CBT delivered by lay counselors for 9 consecutive weeks. In the TAU group, 116 children received the usual school services provided by psychology teachers. The primary outcome was the reduction in PTSD severity, which was assessed with the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5). The secondary outcomes included the reduction in PTSD severity and the remission of PTSD, both of which were measured with the PTSD checklist-5 (PCL-5). Secondary outcomes also included the reduction in depression severity and the reduction in generalized anxiety severity. Blinded assessments were collected at baseline, posttreatment (primary endpoint), and 3-month follow-up. This trial is registered with Chinese Clinical Trial Registry, ChiCTR1900027131. At posttreatment, the intervention group scored significantly lower than the TAU group on PTSD-RI-5 PTSD (30.98 vs. 39.22; adjusted mean difference [AMD],-7.35; 95% CI,-11.66 to-3.04), PCL-5 PTSD (28.78 vs. 38.04; AMD,-8.49; 95% CI,-13.23 to-3.75), depression (5.52 vs. 7.96; AMD,-1.63; 95% CI,-2.50 to-0.76), and generalized anxiety (7.23 vs. 8.64; AMD,-1.21; 95% CI,-2.20 to-0.23). The remission of PCL-5 PTSD was also significantly higher in the intervention group (42.86% vs. 13.54%, χ 2 =13.10, P<0.001). These two groups showed a similar level of symptoms at the 3-month follow-up. The group-based TF-CBT can significantly alleviate PTSD, depression, and generalized anxiety right after treatment in Chinese children who suffer from different types of trauma. But the long-term effects of this intervention need to be further tested. This intervention can be delivered by trained lay counselors in low- and middle-income countries. None.

The relationship between extended kin resources and children's healthcare utilization: An analysis of family networks

Extended kin serve as key sources of financial, social, and instrumental support for young children and their families. In impoverished settings, the ability to rely on extended kin for investments, information, and/or in-kind support to access health care when needed may be particularly important in buffering children against poor health outcomes and mortality. Given data limitations, little is known about how specific social and economic characteristics of extended kin shape children's healthcare access and health outcomes. We use detailed household survey data from rural Mali, where related households co-reside in extended family compounds, a living arrangement typical across West Africa and other settings globally. We examine how specific social and economic characteristics of extended kin residing in close geographic proximity affect children's healthcare utilization in a sample of 3948 children under five years of age reporting illness in the preceding two weeks. Absolute wealth among extended family networks is associated with utilization of any healthcare and healthcare with a formally-trained provider, an indicator of health service quality (adjusted odds ratio (aOR) = 1.29, 95% CI 1.03, 1.63; aOR = 1.49, 95% CI 1.17, 1.90, respectively). Net of maternal characteristics, educational attainment and decision-making power of extended female relatives of reproductive age in the concession network are powerful predictors of any healthcare utilization (aOR = 1.69, 95% CI 1.18, 2.42; aOR = 1.59, 95% CI 1.27, 1.99, respectively). Labor force participation among extended relatives is not associated with healthcare utilization outcomes among young children, while maternal labor force participation is predictive of utilization of any care and care with a formally-trained provider (aOR = 1.41, 95% CI 1.12, 1.78; aOR = 1.36, 95% CI 1.11, 1.67, respectively). These findings underscore the importance of financial and instrumental support from extended family and illuminate the ways extended families work together to return young children to health in the face of resource constraints.

Race, Neighborhood Opportunity, and Life-Threatening Complications in Children With Cancer: A Moderated Mediation Approach.

Racial disparities exist in the incidence and severity of life-threatening complications of childhood cancer and its treatment. Little research has been conducted to examine the sociocultural pathways that are underlying these inequities. This study examined the association between race and complications and the intermediary pathway of a child's access to opportunity in the neighborhood environment. A secondary objective was to determine if this indirect effect differs as the child becomes older and exposure to the neighborhood environment increases. This is an analysis of publicly available data. Regression models estimated direct associations between race and complications, as well as the effect of the mediator, neighborhood opportunity. Moderated-mediation analysis was used to determine the conditional influence of age. Compared with non-Hispanic White children, non-Hispanic Black and Hispanic children are at increased odds of developing 1 or more life-threatening complications when hospitalized with cancer. Neighborhood opportunity is a significant indirect pathway underlying these relationships. This intermediary effect is significant only for older children. Neighborhood opportunity is a significant indirect pathway underlying the racial inequities in the risk of life-threatening complications. This effect is significant only for older children. The inclusion of indicators such as inequitable allocation of resources to highly segregated neighborhoods and rigorous statistical model development in outcomes research are critical in addressing and mitigating racial disparities in childhood cancer.

Mother's Experience with COVID-19 in Breastfeeding: A Phenomenological Study.

The COVID-19 pandemic has disrupted mothers' and children's access to essential health services. Concerns about the transmission of COVID-19 to infants resulted in strict procedures, which then caused delays in initial contact and breastfeeding. This delay then impacted the well-being of mothers and babies. This study aimed to explore the experience of mothers with COVID-19 in breastfeeding. This study was qualitative research with a phenomenological approach. Participants were mothers with a confirmed history of COVID-19 during the breastfeeding period either in 2020, 2021, or 2022. Semi-structured in-depth interviews were conducted with 21 mothers. Data were analyzed using thematic analysis. Three themes were obtained: breastfeeding during the mother was confirmed COVID-19, changes in the mother's condition, and social support received by the mother. Based on this theme, it can be seen that mothers are temporarily separated from their newborns, which causes breastfeeding difficulties. Mothers confirmed to have COVID-19 in 2020 and 2021 appear to have more significant concerns about transmitting COVID-19, as indicated by the mother's decision not to breastfeed and to undergo separate isolation with the baby. Mothers need support to continue to breastfeed. The benefits obtained from breastfeeding are far more significant than efforts to prevent transmission by separating mother and baby, so mothers should be encouraged to continue breastfeeding.

Impact of Coinsurance Reduction Policy on Healthcare Utilization Among Children Under 15.

On October 1, 2017, a new coinsurance reduction policy for children under 15 was introduced to minimize the lack of inpatient medical services for economic reasons and secure children's access to medical care. This study analyzes the effect of this coinsurance reduction policy on healthcare utilization using data from the National Health Insurance Service-National Sample Cohort between 2015 and 2019. Groups were classified by 3 case groups and a control group according to age. The dependent variables were inpatient cost, admission, length of hospitalization, outpatient cost and visit, and total cost. The difference-in-differences method was used to examine changes in healthcare utilization among the case and control groups after policy implementation. Children of the age group 1-5 exhibited an increase in inpatient services and a decrease in outpatient services. There was a 16.17% increase in inpatient cost, 8.55% increase in inpatient admission, 10.67% increase in inpatient length of hospitalization, -9.14% decline in outpatient cost, and -6.79% decline in outpatient visits. Regarding children in the age groups of 6-10 and 11-15, the effect of the policy was inconclusive. The reduction in coinsurance rate policy in hospitalization among children has increased inpatient services and reduced outpatient services for 1-5-year-olds-a substitute effect was observed in this group. There is need for further research to examine the long-term effects of the coinsurance reduction policy.

A qualitative study of parental strategies to enable pre-school children's outdoor and nature experiences during COVID-19 restrictions.

Outdoor and nature experiences including play have been shown to be beneficial for children's physical, cognitive, social and emotional development. Parents/carers play an important role in encouraging or impeding their child's access to the outdoor environment and participation in outdoor play. The COVID-19 pandemic and associated restrictions on free movement and social interactions placed an unprecedented pressure on families to manage the drastic change in their daily routines. This paper reports findings from two combined data sets generated in 2020 during the COVID-19 pandemic and provides a deeper understanding of the interconnected nature of how contextual factors influence parenting processes and outcomes relating to young children's outdoor and nature experiences and subsequent child health. Findings have the potential to inform the messaging of existing outdoor play policies and the content of new interventions aiming to promote the exposure of children to the natural outdoor environment.

Health disparities associated with access to disability evaluations for toddlers in Early Head Start.

The aim of this investigation was to examine developmental, sociodemographic and familial factors associated with parent reported access to an evaluation in an Early Head Start sample. Children with developmental disabilities often require evaluations to access early interventions, which can improve their long-term outcomes. This study (n=191) examined how developmental, sociodemographic and parent factors at age 2 were associated with parent reporting the child being evaluated by age 3. Two logistic regression analyses were conducted. The first model included children at age 2 with scores at least in the monitoring zone of developmental risk, and the second model included children with high developmental risk. The first model found that children in the monitoring zone of developmental risk were more likely to be evaluated per parent report if they were born preterm, male, with increased behaviour problems, higher economic risk, increased maternal education, increased parental depressive symptoms and in urban areas and less likely if they were of Black or Hispanic/Latino ethnicity, had no health insurance or more home disorganisation. The second model found that children with high developmental risk were less likely to be evaluated per parent report if they were female, of Hispanic/Latino ethnicity, had better language skills and increased home disorganisation and more likely if their parents reported increased depressive symptoms or less economic risk. This study highlights barriers associated with access to developmental and disability evaluations for children in at-risk families. Health disparities are negatively associated with children's access to evaluations, even when supported by systems like Early Head Start.

Measuring children's and adolescents' accessibility to greenspaces from different locations and commuting settings

Recent evidence underscores the importance of greenspace exposure in promoting physical activity, and in having a positive impact on mental health and cognitive development. Accessibility has been identified to be the primary motivating factor when it comes to encouraging greenspace use and, correspondingly, exposure. Existing quantitative approaches to measuring greenspace accessibility predominantly focus on the areas surrounding home locations, often disregarding access from other settings such as schools or workplaces, exposures while on the move, and mobility differences among different population age groups. This article introduces a novel method to measure greenspace accessibility that considers access from different activity settings (i.e., homes, schools, and the commutes between them) for children and adolescents, while accounting for the dependency of human access on the road network. We use Amsterdam, Rotterdam, and The Hague in the Netherlands as case studies to illustrate the utility of our method. Compared to conventional measures of greenspace accessibility, we show that accounting for school and commuting settings, in addition to residences, captures previously untapped accessibility aspects for both children and adolescents. Our approach can be replicated in other cities worldwide, with the aspiration to provide planners and public health policy-makers with a methodological tool that can help in evaluating access and use of greenspaces when designing health-promoting interventions.

Association between Community Social Capital and Access to Dental Check-Ups among Elementary School Children in Japan.

The association between parental social capital and a child's access to dental check-ups has been reported, but few studies have focused on dental check-ups. The present study investigated the association between parental social capital and access to dental check-ups among first-grade elementary school children (6-7 years old) in Japan. We analyzed cross-sectional data of first-grade elementary school children (6-7 years old) in Adachi City, Tokyo, Japan. Community social capital (the total score of social trust, cohesion, mutual aid) and child's dental check-ups (dental check-ups for purposes other than treatment at least once a year) were assessed by questionnaire surveys for parents of the first graders from all 69 elementary schools in 2017 (n = 5260; response rate: 81.6%) and 2019 (n = 5130; response rate: 78.8%). Multilevel Poisson regression analysis, adjusted for children's age in months, gender, mother's educational attainment, mother's employment status, having siblings, living with grandparents, and the density of dental clinics in the school district, was applied. Of the 7936 respondents included in the analysis, 82.7% of children received dental check-ups at least once a year. Individual-level social capital was positively associated with children's dental check-up utilization (prevalence ratio, PR = 0.935 per one interquartile range, IQR; 95% confidence interval, CI: 0.877, 0.996). Community-level social capital was not significantly associated with children's dental check-up utilization (PR = 0.934 per one IQR; 95% CI: 0.865, 1.008). Promoting individual-level social capital, but not community-level social capital, may improve dental check-ups among elementary school children in Japan.

Four Temporary Waterslide Designs Adapted to Different Slope Conditions to Encourage Child Socialization in Playgrounds

Increased urbanization has decreased children's access to various natural outdoor environments. To counteract this deficiency in early life experiences, we designed four temporary waterslides, each tailored to different city-side park conditions. The waterslides were simple to construct, with frames built from easy-to-attain resources such as bamboo rods from a local forest and simple pipes and joints overlaid by a tarp. Plywood boards, cardboard, and a tarp were used to create a pool at the foot of the slides, which were placed on existing slopes or stairs in each park. Water was continually released down the slide during each 1-2 h event. At each park event, children gathered spontaneously to use the slides and interact socially. No serious accidents occurred during the waterslide trials. To understand how the children used each waterslide, the activity at the waterslides was recorded by video. The minute of the highest activity level at the waterslide was quantitatively analyzed to determine the lines of flow surrounding the waterslide and the mean and maximum speeds attained while using the waterslide.

Anxiety symptoms among children visiting a pediatric emergency center in Qatar during the COVID-19 pandemic: A cross-sectional study.

Although the evidence base regarding the impact of the COVID-19 pandemic on children has been growing, descriptions of their experiences remain scarce. In this cross-sectional study, the authors used the Child-Reported Spence Children's Anxiety Scale to collect data from 91 children visiting a pediatric emergency center in Qatar during the pandemic. Around 25% of the children reported elevated levels of overall anxiety. Obsessive-compulsive symptoms were the most common, with 59.3% of children reporting elevated symptoms. The mean score of physical injury fears was significantly affected by gender, with females having higher scores. Overall rates for elevated anxiety symptoms were similar in natives and expatriate children. The findings suggest that the effects of the pandemic on children may depend on several vulnerability factors, including developmental age and gender. This study highlights the need to plan multidisciplinary strategies to enhance children's access to mental health services during and after the current health crisis.

Understanding the impacts of floods on learning quality, school facilities, and educational recovery in Indonesia.

This research is among the first pieces of work to use the comprehensive school safety (CSS) framework to assess the impacts of floods on quality learning and education infrastructure. The CSS framework is employed here to identify the level of disruption to education services following floods in Jakarta, Indonesia, in 2013. The paper poses three key questions, concerning: (i) disruption to children's access to quality education during the flood emergency in 2013 and the early recovery phase; (ii) the impact of the floods on a school's physical infrastructure; and (iii) the effectiveness and level of success of the 2013 flood responses by relevant stakeholders. Combining quantitative and qualitative strategies, the paper examines the experiences of 100 schools in Jakarta. The findings suggest that the CSS framework offers a more nuanced approach to assessing post-disaster education needs. Moreover, it is also relevant for examining the relationship between the COVID-19 pandemic and relative losses in the education sector.

The problem with faith-based carve-outs: RSE policy, religion and educational goods

AbstractIn September 2020, relationships and sex education (RSE) became compulsory in all English secondary schools, and relationships education became compulsory in all English primary schools, marking a significant step forward in the fight to establish children's rights. Although the new RSE regime will help to ensure that many English schools provide pupils with a far more comprehensive RSE curriculum than ever before, the statutory guidance underpinning it includes a number of caveats that mean, although the subject is compulsory, not all children will receive the same content. Arguably, along with the right to withdraw (which is often exercised on religious grounds), the most insidious of these ‘carve-outs’ allows faith schools to teach RSE according to their ‘distinctive religious character’. This exemption has been used to defend the use of religious RSE resources that critics maintain are misogynistic, homophobic and often draw heavily on pseudoscience, as well as to justify leaving certain topics (such as same-sex relationships or trans rights) out of classroom discussion altogether. Drawing on empirically informed normative case studies and recent reforms to the curriculum in Wales, I argue that faith-based carve-outs to RSE policy imperil children's access to a distinct package of educational goods. Using a recent framework for educational decision-making based on these goods developed by Brighouse et al. I go on to conclude that such policies are politically and morally unjustifiable (at least if one agrees that the relevant package of goods is desirable). I further maintain that, even when considered from the perspective of human rights law—which is often given as a pragmatic reason to allow more permissive policies with respect to teaching topics that may impinge upon parents’ deeply held convictions—there are no necessary grounds for governments to legislate for the subject to be circumscribed by the religious beliefs of parents or the faith ethos of the schools children attend.

Parental Perceptions of Their Children's Access to Household Firearms

To provide a nationally representative estimate of the proportion of gun owners who report a child has independent access to one of their guns, and to describe characteristics of these gun owners relative to other gun-owning parents. We conducted a cross-sectional analysis of online survey data collected in 2019 from a nationally representative sample of US adults in households with firearms (n=4030, response 65%). The sample comprised gun-owning respondents living in homes with children (n=689) who were asked questions about their firearms, including how they were stored, and about who other than themselves had access to their guns: "If you were not there, who in your household could get one of your guns (and load it if it is not loaded already) if they needed to?" Twelve percent of US gun owners in homes with children report that a child has independent access to one of their guns (about one-fifth of those having children under age 12 years only). Gun owners who reported child access were more likely than those who reported no child access to store guns, unlocked and loaded, but still one-fifth of those reporting access, stored all guns locked and unloaded. We find that more than 10% of gun owners with children report that a child can independently access one of their guns, including parents who store all guns locked and unloaded; suggesting that guidance to parents should focus on access in addition to firearm storage.

5.N. Workshop: Children first: do health systems pay enough attention to their youngest constituents?

Abstract This workshop aims to bring together a range of insights on how health systems have dealt with child health and health care, highlighting both successes and challenges. For children, access to health care is vital. It impacts their physical and emotional health and wellbeing and largely determines whether they can reach their full potential as adults, which is also important to their families and society at large. Consequently, it comes as no surprise that he 1989 UN Convention on the Rights of the Child, which was ratified by all European countries, guarantees a fundamental right to healthcare for all children. However, various national governments do not fully comply with the Convention, and evidence exists that children may not always enjoy the necessary access to meet their needs. In 2021, Doctors of the World (DoW) concluded that there are urgent questions about the welfare and health of vulnerable children across Europe, based on the increase in children seeking healthcare from DoW clinics instead of the national health system. This concerning trend is not captured well enough in available statistics. What is more, the COVID-19 pandemic and the Ukrainian refugee crisis raise additional concerns as to how health systems will deal with the observed increases in related paediatric sequelae and mental health needs. The aims of this workshop are therefore to stimulate discussion around better understanding children's access to health care and how it relates to health system performance, and provide impetus for new initiatives that can improve health care for children. The workshop will take a hybrid format, kicking off with three short presentations followed by a round table discussion and engagement with the audience. The presentations will cover the regulatory framework for children's access to health care in European countries; identified bottlenecks of health system performance specific to child services from a range of countries around the world; and the impact of COVID-19 on hospital care for children based on the example of one European country. Key messages • Ensuring children’s access to health care is now more important than ever; a lot more can and should be done at all levels. • More and better data about children’s health and health care access is necessary to enable effective policies; collecting it should become a health system priority.

Do EU countries comply with the right to healthcare under the UN Convention on the Rights of the Child?

Abstract Children's health status varies within and between European countries. To what extent this is associated with access barriers to timely and effective care children may face is not yet fully understood. Article 24 of the UN Convention on the Rights of the Child (UNCRC) guarantees a fundamental right to healthcare for all children, regardless of their legal status in terms of citizenship, residence, or insurance. Using information contained in the Health Systems in Transition reports produced by the European Observatory on Health Systems and Policies, additional relevant literature, and responses to a structured questionnaire filled out by key informants from all 27 EU MS and the United Kingdom, we evaluated whether European countries comply with the specific obligations that can be drawn from the UNCRC. While all countries considered have ratified the UNCRC, only four countries have included a specific disposition in their legislation that establishes an unconditional, universal right to health services for all children living in their territory. In other countries, the fragmented way of defining children's access rights can create gaps in legislation which can leave certain groups of children without coverage. Children with irregular residence are the most vulnerable group when it comes to eligibility problems, but other groups of children may also fall between the cracks or be only entitled to restrict-ed or conditional access to health care. These insights show that international treaties, such as the UNCRC, can help monitor health coverage and ensure that basic human rights to health services are guaranteed in times of crisis, such as the Covid-19 pandemic and the Ukraine Displacement, but may be insufficient without concrete transposition into national legislative frameworks.