Child Occupant Research Articles

A Study on Home Safety Practices to Prevent Childhood Injuries Among Mothers

Introduction: Most unintentional injuries in children occur at home and many are preventable. Mothers and family’s role in injury prevention is very important. We intended to study the role of home safety practices in prevention of childhood injuries.
 Methods: This descriptive cross-sectional study was done using a questionnaire. Mothers of children aged one to five years were assessed about home safety practices to prevent childhood injuries. Questionnaire included personal data about the participants such as age, occupation, education, family size and number of children. Safety practices followed by mothers to prevent six types of injuries namely burn, cut, fall, drowning, poisoning and choking were noted.
 Results: Of the 150 mothers interviewed, 104 were aged below 30 years, 88 were educated up to high school and 130 were housewives. Thirty mothers reported some kind of injury sustained by their children, of which twenty-one were falls. Among precautionary measures mother – behaviour safety initiatives e.g. checking the hot water temperature (88%) or not leaving child alone (92%) got better responses than passive or environmental modifications e.g. using electrical – outlet protection (44%), staircase gates (52%). Overall safety practices were reasonably good with the majority scoring above 50%. Age, education, number of children, occupation of the mother, child age and history of injury did not correlate with the level of safety practices.
 Conclusions: Mothers’ home safety practices to prevent childhood injuries were relatively better in majority of the study population. Mother’s age, educational level, occupation, number of children, child’s age and history of injury did not affect how mother and her family practiced safety measures.

Partners in play: Exploring ‘playing with’ children living with severe physical and intellectual disabilities

Introduction Play occupation is central to children’s occupational lives and play is established as a fundamental right. While children with disabilities are at increased risk of play deprivation, few studies have explored the play occupation of children living with severe physical and intellectual disabilities. Method Informed by an ethnographic approach, this qualitative study involved 17 participants including five families of children with severe disabilities and six classroom staff. Methods combined observations of children’s play with adult interviews and focus groups to explore factors that influence play in home and school contexts. Findings were analysed using thematic analysis. Findings Three themes emerged: (a) play as an occupation, play as an activity; (b) an empowered and empowering play partner; (c) the ‘just-right’ play object and environment. Conclusion The influence of an empowering and empowered play partner combined with the suitability of the object and environment was central to successful play. A commitment to play for fun, for the wellbeing of these children, and by ‘playing with’ and not ‘doing-to’ the child was fundamental. Although the findings are specific to this study, play facilitators may use them to inform future play interactions through an enhanced understanding of empowerment and enablement for successful play occupation.

Gender-Based Pathways to Cognitive Aging in the Mexican-Origin Population in the United States: The Significance of Work and Family.

This study uses the life course perspective to explore the role of key midlife factors (occupation and number of children) for gender- and nativity-based pathways to cognitive aging for older Mexican Americans. Using the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE, 1993/1994-2016, n = 2,779), this study presents (a) cognitive impairment trajectories over 20 years of data and (b) multinomial logistic regression analyses of trajectory group membership by lifetime occupation and number of children, controlling for educational attainment. For older Mexican American men, lifetime employment in agricultural occupations is associated with elevated risk for late-life cognitive impairment. Delayed risk for impairment is observed for U.S.-born men who were employed in factory work (e.g., production and repair) and in Mexican-born men who were employed in occupations with skilled or supervisory requirements. For all women, labor force participation, especially in skilled occupations, is related to a delayed risk of cognitive impairment. Number of children is unrelated to impairment for men; however, women with five or more children (compared to women with two to four children) are at risk for consistent and rapid cognitive impairment in late life. Late-life cognitive health disparities that disproportionately impact the Mexican American population can be addressed by improving access to educational and occupational opportunities in early and midlife. This study points to key areas of intervention within work and the home for the Mexican-origin population.

The short-term effects of COVID-19 outbreak on dietary diversity and food security status of Iranian households (A case study in Tehran province)

Currently, the COVID-19 outbreak is spreading fast in 185 countries and has engaged most people around the world. COVID-19 imposes severe and tragic consequences on people’s health due to the high rate of spread and potentially fatal impacts. In this study, the association of socio-economic factors with food security and dietary diversity is assessed before and during the COVID-19 pandemic. Data from 299 respondents were collected by an online standard questionnaire. Household Dietary Diversity Score (HDDS) and Household Food Insecurity Access Scale (HFIAS) were calculated. A multinomial regression model was applied to determine factors associated with HDDS and HFIAS before and during COVID-19 outbreak. Food security of Iranian households improved during the initial COVID-19 pandemic period (P < 0.001). Households reduced consumption of some food groups during the COVID-19 pandemic compared to the pre-COVID-19 period. Key socio-economic factors associated with food insecurity during the COVID-19 pandemic included personal savings, household income, employment status of head of household, and nutrition knowledge of head of household. During the COVID-19 outbreak, household size, head of household’s occupation, personal savings, and number of male children were significantly associated with dietary diversity. Distributing free food baskets to poor households, extending e-marketing, providing nutrition consultations, and organizing donations to support infected households may increase household dietary diversity and improve food security status during a pandemic such as COVID-19. Vulnerable populations in countries experiencing food insecurity, such as Iran, should be supported — not just by providing medical care and personal protective equipment, but also with flexible safety nets and food-based intervention programs to respond to population needs.

A percepção do cuidador familiar acerca do brincar de crianças em vigilância do desenvolvimento em um serviço de terapia ocupacional no estado do Pará

Objetivos: Compreender a percepção do cuidador familiar acerca do brincar de crianças em programas de vigilância do desenvolvimento. Métodos: Abordagem qualiquantitativa, de natureza descritiva e exploratória. O estudo ocorreu na Escola Superior da Amazônia – ESAMAZ, no projeto de vigilância do desenvolvimento ACRESCER, após critérios de inclusão e exclusão participaram quatro cuidadores familiares. A análise dos dados ocorreu pela interpretação e atribuição de significados dos principais dados obtidos a partir da análise de conteúdo. Resultados: 75% dos cuidadores são mães, com renda acima de quatro salários mínimos, e 75% com nível de escolaridade de ensino superior completo. A idade das crianças acompanhadas variou em um intervalo de um ano e seis meses à seis anos. Os dados qualitativos foram organizados em quatro eixos temáticos, o tempo da brincadeira, o brincar com outras crianças, o brincar e o desenvolvimento da criança, e a participação do cuidador durante o brincar. Conclusão: Os cuidadores familiares consideram suficiente o tempo de duração do brincar, apresentam a percepção da brincadeira como fonte importante para o desenvolvimento infantil e como principal ocupação da criança, acreditam que o brincar contribue no favorecimento do vínculo familiar e o consideram importante para o desenvolvimento das relações sociais.

Now, being, occupational: Outdoor play and children with autism

ABSTRACT Play is the primary occupation of children and the right for children to play has been acknowledged internationally, for all children, including those with disabilities. However, there is concern that outdoor play is declining, thus warranting more focused investigation to better understand the evolving nature of outdoor play. The purpose of this study was to explore the outdoor play occupations and environments of children with autism, to understand the place of outdoor play in their lives. A qualitative methodology was used, drawing from ethnographic principles. Eight participants were recruited from one primary school in Ireland; five children with autism aged six-to-nine, and three staff members. Multiple methods were employed, including interviews, picture elicitation, observations, and behavioural mapping. Thematic analysis was used to analyse data and three core themes identified, relating to play form, play environments, and play challenge. Children with autism in this study enjoyed many forms of outdoor play. Their preferences were for active play with varied sensory elements including running, jumping, swinging, climbing, and sliding. Play occupations with opportunities for challenge, mastery, and engagement in risky play were particularly favoured, alongside preferences for imaginative play, play with natural components, and social interaction. Play engagement was most evident in environments with higher play value. This work contributes to a reconceptualization of the study of play occupation as a focus on the ‘now’ of childhood. By focusing on being and not becoming, we argue for rejecting a deficit model in favour of a rights-based occupational justice perspective to emancipate play.

A Study on the Use of Child Restraint System (CRS) in Indonesia and Vietnam

&#x0D; &#x0D; &#x0D; As technology develops in passenger vehicles, occupant safety is an issue that cannot be ignored, especially with regard to child occupants. Therefore, the child occupant safety should be given emphasis in the car assessment program to increase car safety levels and to primarily ensure children’s safety during travels. To this end, ASEAN NCAP through its child occupant protocol recommends the use of a Child Restraint System (CRS). This study evaluates the level of vehicle users’ awareness of the use of CRS (ownership and usage) in Indonesia and Vietnam. In this study, 336 Indonesian and 119 Vietnamese parents with children aged six years or below were asked to fill out the questionnaire both online and in written form. In Indonesia, the data showed that 70% of the participants owned CRS, while the rest either unrestrained or used the vehicle seat belts for their children. In Vietnam, 77% of the participants owned CRS. Moreover, there were approximately 26% respondents in Indonesia, and 9% in Vietnam who did not use the CRS. Parents did not use CRS for their children due to several reasons, namely children refusal and parents’ preference to place children on their lap. In Indonesia, only 58% of children used proper CRS according to their age group, and 35% of the parents installed CRS properly per the user manuals. In addition, more than 50% of the 28 surveyed vehicles in Indonesia were fitted with ISOFIX standard CRS attachment. Furthermore, it appears that there was high enthusiasm among parents to use CRS based on their willingness to pay for it. However, initiatives such as social awareness campaigns or even regulation should be considered to increase CRS usage both in Indonesia and Vietnam.&#x0D; &#x0D; &#x0D;

Booster cushion design effects on child occupant kinematics and loading assessed using the PIPER 6-year-old HBM and the Q10 ATD in frontal impacts

Objective Our objective was to study the effect on child occupant kinematics and loading by differences in booster cushion designs and attachment in a frontal impact. Methods Three different booster cushion designs were exposed to a frontal impact in vehicle rear seat interiors. The boosters were selected based on their difference in shape, stiffness, and guiding loop design. Tests were run varying the shoulder belt routing above or under the guiding loop, in addition to with or without attachment of the booster cushion to the vehicle ISOFIX anchorages. Eighteen simulations with the finite element PIPER 6-year-old human body model (HBM) were run investigating all combinations of parameters, in addition to 3 sled tests with a Q10 anthropomorphic test dummy (ATD). Results Across 2 different child sizes, using an HBM and an ATD, respectively, consistent sensitivity to the booster design differences were seen. Boosters providing similar initial static belt fit can result in different occupant responses during a crash, due to the design of the boosters and their dynamic performance. Compression of the booster cushion resulted in a delayed pelvis restraint, influencing the upper body kinematics. The guiding loop design as well as the belt routing above or under the guide also influenced the upper body kinematics and shoulder belt interaction. Conclusions Early pelvis coupling to initiate torso pitch, and thereby an upper torso motion controlled by the shoulder belt, is the preferred occupant protection for booster-seated children. A stable mid-shoulder belt position centered over the chest initially is a prerequisite. Additionally, it was seen that the design of the guiding loops helps provide favorable interaction with the torso during the crash. The option to allow the shoulder belt to be placed above and under the guiding loops will accommodate a larger span of child sizes and adapt to more vehicle seat belt geometries. This study provides evidence that the design of the booster cushion plays an important role in creating an early pelvis coupling, as well as supporting favorable torso–shoulder belt interaction.

Determinants and impact of role-related time use allocation on self-reported health among married men and women: a cross-national comparative study

BackgroundResearch on the effects of marriage on health maintains that there is a gender-specific gradient, with men deriving far greater benefits than women. One reason provided for this difference is the disproportionate amount of time spent by women on housework and childcare. However, this hypothesis has yet to be explicitly tested for these role-related time use activities. This study provides empirical evidence on the association between role-related time use activities (i.e. housework, childcare and paid work) and self-reported health among married men and women.MethodsData from the Multinational Time Use Study (MTUS) on 32,881 men and 26,915 women from Germany, Italy, Spain, the UK and the US were analyzed. Seemingly unrelated regression (SUR) models and multivariable logistic regression were used to estimate the association between role-related time use activities and self-reported health among married men and women.ResultsThe findings showed that education, occupation and number of children under 18 years old in the household were the most consistent predictors of time allocation among married men and women. Significant gender differences were also found in time allocation, with women sacrificing paid working time or reducing time devoted to housework for childcare. Men, in contrast, were less likely to reduce paid working hours to increase time spent on childcare, but instead reduced time allocation to housework. Allocating more time to paid work and childcare was associated with good health, whereas time spent on housework was associated with poor health, especially among women.ConclusionsTime allocation to role-related activities have differential associations on health, and the effects vary by gender and across countries. To reduce the gender health gap among married men and women, public policies need to take social and gender roles into account.

Validity and Reliability of the Persian Version of the Utian Quality of Life Scale (UQOL)

Background:Menopause can have adverse effects on the quality of life of postmenopausal women. The main purpose of this study was to determine the Validity and Reliability of the Persian version of the Utian Quality of Life Scale (UQOL) in iranian postmenopausal women in 2019 Methods: The questionnaire was first translated into Persian. After its adaptation with the original version and backward translating it into English, the face and content validity were assessed by a group of experienced experts. To this end, exploratory factor analysis was performed by Principal Factor Analysis method with varimax rotation. Convergent validity was assessed by correlating the Persian version of UQOL and the 36-Item Short Form Health Survey (SF-36). Finally, the mean quality of life score of postmenopausal women in different domains as well as its mean in different domains based on age, education level, menopausal age, and number of children were calculated. Results: Regarding reliability, the alpha coefficient was obtained 0.66 for occupation domain, 0.52 for health domain, 0.50 for emotional domain, and 0.90 for sex domain. There was a significant relationship between quality of life and age, menopausal age, occupation and number of children in all domains in menopausal women. There was a significant relationship between BMI and quality of life score in postmenopausal women only in physical health domain. Conclusion:it seems this questionnaire can’t be used in research on the quality of life of postmenopausal women.

Exploring Social Interactions Between Students With Autism Spectrum Disorder (ASD) and Their Typically Developing Peers in an Interest-Based Setting

Abstract Date Presented 03/27/20 This abstract describes the social characteristics observed between students with ASD and their typically developing peers in an inclusive, interest-based after-school club. The results of this study can inform the profession and related fields of the impact that inclusive, strengths-based contexts have on facilitating social interactions and promoting meaningful participation in nonacademic occupations for children with ASD. Primary Author and Speaker: Denise Mañago Additional Authors and Speakers: Tara Brennan Contributing Authors: Sana Ahmed, Amanda Rodriguez, Laura Senande, Michael Thorsen, Yu-Lun Chen, Kristie Koenig, Wendy Martin, Regan Vidiksis

Effects of an Unstructured Free Play and Mindfulness Intervention on Wellbeing in Kindergarten Students.

Play is known as the core occupation of young children as it lays a foundation for their early development and physical, emotional and social wellbeing. Literature suggests that unstructured free play and mindfulness interventions may independently promote wellbeing among preschoolers. However, there is no clear evidence of their combination in supporting wellness in early learning environments. We conducted a quasi-experimental study with 42 children aged four to six years, attending two kindergartens in Hong Kong. The intervention included unstructured play with non-directional loose parts (play materials), conducted outdoors for one hour daily followed by a mindfulness intervention for 10 min per day indoors. The intervention lasted for five consecutive days. We examined happiness and aspects of playfulness before and after the intervention, finding a significant increase in all areas. Given greater freedom in play choice, children showed more disruptive behaviors during unstructured play than the control group engaging in recess as usual. We conclude that unstructured play in addition to mindfulness intervention is effective in promoting students’ happiness and playfulness, both of which may help maintain mental health and wellbeing amid stressors such as transition and separation. The increased disruptive behavior requires additional investigation.

A Systematic Review on Clinimetric Properties of Play Instruments for Occupational Therapy Practice

Play is considered the main occupation for children. Pediatric occupational therapists utilize play either for evaluation or intervention purpose. However, play is not properly measured by occupational therapists, and the use of play instrument is limited. This systematic review was aimed at identifying play instruments relevant to occupational therapy practice and its clinimetric properties. A systematic search was conducted on six databases (Academic Search Complete, CINAHL, MEDLINE, Psychology and Behavioral Science Collection, Scopus, and ASEAN Citation Index) in January 2020. The quality of the included studies was evaluated using Law and MacDermid's Appraisal for Clinical Measurement Research Reports, and psychometric properties of play instruments were evaluated using Terwee's checklist while the clinical utility is extracted from each instrument. Initial search identifies 1,098 articles, and only 30 articles were included in the final analysis, extracting 8 play instruments. These instruments were predominantly practiced in the Western culture, which consists of several psychometric evidences. The Revised Knox Preschool Play Scale is considered the most extensive and comprehensive play instrument for extrinsic aspect, whereas the Test of Playfulness + Test of Environmental Supportiveness Unifying Measure is a promising play instrument for intrinsic aspect on play, where both instruments utilize observation. My Child's Play is a potential questionnaire-based play instrument. However, the current development of play instruments in the occupational therapy field is immature and constantly evolving, and occupational therapists should exercise good clinical reasoning when selecting a play instrument to use in practice.

Occupational Therapy Practice Guidelines for Children and Youth Ages 5-21 Years.

Demand is increasing for activity- and occupation-based interventions to address occupational performance and support maximal participation of children and youth. This Practice Guideline was developed to guide decision making and support best practices in service delivery for children and youth ages 5-21 yr at home, at school, and in the community. The results from three systematic reviews (SRs) of activity- and occupation-based interventions for children and youth ages 5-21 yr were reviewed, synthesized, and translated into recommendations for education, practice, and research. One hundred eighty-five articles were included in the three SRs examining the evidence for interventions to promote activities of daily living, instrumental activities of daily living, play and leisure, and rest and sleep; to improve mental health, positive behavior, and social participation; and to enhance learning, academic achievement, and successful participation in school. The reviews provide evidence for interventions associated with typical concerns addressed by occupational therapy practitioners. On the basis of the evidence, this guideline recommends that occupational therapy practitioners consistently collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence. When guided by evidence, activity- and occupation-based interventions are effective in promoting participation and enhancing performance in valued occupations of children and youth ages 5-21 yr.

Application of Structural Equation Modeling (SEM) in Estimating the Contributing Factors to Satisfaction of TASKA Services in East Coast Malaysia

This research shows the application of the Structured Equation Modeling (SEM) to obtain the best model for studying the relationship between the more efficient and accurate against the findings and the interpretation of the variables. The objectives of the study are to assess the reliability of the developed instrument and to test construct validity of the research instruments in estimating the contributing factors to TASKA service satisfaction. The proportionate stratified random sampling method was used to select a total of 61 TASKAs from three states on the east coast of Malaysia consisting of 273 parents and guardians which are currently using the TASKA services. Validity and reliability of the measurement model in the analysis using Structural Equation Modeling (SEM) method. Measurement models were data-based and fit based on the fit index (CMF) χ2 = 3230.541, with degrees of freedom (df) = 902, CMIN / df = 3.582 (≤5.0), CFI &amp; TLI (≤0.9), and RMSEA = 0.070 (≤0.1). Based on the results obtained, all indices meet standardized metric and assessment tools have proven to be a good instrument. The results show that there are 5 factors that influence parents' satisfaction with the quality of services offered by TASKA. Analysis found that the combination of manage, grow, fees, activity and cost constitutes a strong association to estimate a complete structured equation model while supported by demographic factors such as education level, occupation, location, distance, agency, status and age of children to strengthen the TASKA selection factor. Research shows that this TASKA service model can assist as a guide in improving the existing quality for future improvement. Furthermore, it can be used as a module in providing the best quality of services to the satisfaction of parents and guardians.

Child Presence Detection: Assessment Methodology for ASEAN NCAP

&#x0D; &#x0D; &#x0D; The introduction of Child Presence Detection (CPD) technology under the Child Occupant Protection (COP) pillar in the New Car Assessment Programme for Southeast Asian Countries (ASEAN NCAP) Roadmap 2021-2025 should come with proper assessment methodology to evaluate the effectiveness of such technologies in a vehicle. This paper gives an overview of CPD systems and Vehicle Reminder Systems (VRS), together with their associated technologies. Most importantly, a comprehensive assessment methodology for CPD and VRS that covers the vehicle preparation, occupants’ classifications (i.e., newborn, infant and toddler), assessment procedure, scoring criteria, and implementation plan is also presented. It is hoped that this work could contribute to ASEAN NCAP Roadmap 2021-2025, and gives valuable insights to relevant stakeholders such as the vehicle manufacturers and technology providers.&#x0D; &#x0D; &#x0D;

Evaluation of Adult Occupant Protection on Body Region using Analytical Hierarchy Process: Side Impact Test

&#x0D; &#x0D; &#x0D; ASEAN NCAP is a well-known automobile safety rating program in evaluating new cars for performance against various safety threats on the road. For the Southeast Asian countries, Adult Occupant Protection (AOP), Child Occupant Protection (COP) and Safety Assist Technology (SAT) are domains used in the ASEAN NCAP assessment. In a recent rating protocol, the AOP domain contributes 50 percent of the overall rating system with a maximum 36 points from three main elements consisting of Offset Frontal Test (OFT), Side Impact Test (SIT) and Head Protection Technology (HPT). Frontal crashes resulted in a severe injury that comes from contact with frontal components and ejection; however, side crashes are also reported to have high rates of serious injury and fatality as compared to other crash types. However, in the ASEAN NCAP assessment programme, to what extent side impact test helps to reduce the severity of injury to the car driver and passenger when the collision happened need to be explored. Therefore, the injury of body region on the side impact due to AOP failure were evaluated and reported in this paper to strengthen this program where the recommendation for performing side impact test could be proposed to ensure successful performance. The elements on the side impact test were extracted and decomposed from the existing structure. Next, input from the expert panels of various related backgrounds regarding the injury of body region on side impact test was gathered and evaluated using the Analytical Hierarchy Process (AHP). The result shows that the head, neck, and chest have the highest rank, followed by an abdomen with a Consistency Ratio (CR) of 0.0079. The finding of this paper will help to evaluate the existing side impact test in the AOP assessment.&#x0D; &#x0D; &#x0D;

Factors Affecting Child Injury Risk in Motor-Vehicle Crashes.

Current recommendations for restraining child occupants are based on biomechanical testing and data from national and international field studies primarily conducted prior to 2011. We hypothesized that analysis to identify factors associated with pediatric injury in motor-vehicle crashes using a national database of more recent police-reported crashes in the United States involving children under age 13 where type of child restraint system (CRS) is recorded would support previous recommendations. Weighted data were extracted from the National Automotive Sampling System General Estimates System (NASS-GES) for crash years 2010 to 2015. Injury outcomes were grouped as CO (possible and no injury) or KAB (killed, incapacitating injury, nonincapacitating injury). Restraint was characterized as optimal, suboptimal, or unrestrained based on current best practice recommendations. Analysis used survey methods to identify factors associated with injury. Factors with significant effect on pediatric injury risk include restraint type, child age, driver injury, driver alcohol use, seating position, and crash direction. Compared to children using optimal restraint, unrestrained children have 4.9 (13-year-old) to 5.6 (< 1-year-old) times higher odds of injury, while suboptimally restrained children have 1.1 (13-year-old) to 1.9 (< 1-year-old) times higher odds of injury. As indicated by the differences in odds ratios, effects of restraint type attenuate with age. Results support current best practice recommendations to use each stage of child restraint (rear-facing CRS, forward-facing harnessed CRS, belt-positioning booster seat, lap and shoulder belt) as long as possible before switching to the next step.

Affordability and Availability of Child Restraints in an Under-Served Population in South Africa.

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.

Relationship between screen-time and hand function, play and sensory processing in children without disabilities aged 4-7years: A exploratory study.

Screen-time has become a regular occupation for young children at home and school, with little evidence of its impact on children's developmental skills. This study explored the association between children's screen-time, fine motor, in-hand manipulation (IHM), visual-motor integration (VMI), sensory processing (SP) and parent-reported play skills. The fine motor, IHM, VMI, SP and play skills of a sample of 25 Australian children without disabilities (Mage=6.2years, SD=1.03; 64% girls) were assessed using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, Test of In-Hand Manipulation-Revised, Berry Buktenica Developmental Test of Visual-Motor Integration Sixth Edition, Sensory Processing Measure-Home Form and Pretend Play Enjoyment Developmental Checklist (PPEDC). Parents completed a week-long log of their child's screen-time. Spearman's rho correlations and linear regressions with bootstrapping were used for data analysis. Statistically significant moderate level negative correlations were found between Total Screen-Time (TST) and VMI skills (r=-.67, p<.01); Interactive Screen-Time and IHM abilities (r=-.46, p<.05) and TST and bilateral coordination skills (r=-.42, p<.05). There were significant negative correlations between SP ability and both TST (r=-.53, p<.01) and Watching Screen-Time (r=-.66, p<.01). When the PPEDC Object Substitution variable was entered into a regression model as a co-variate of hand function, it appeared to lessen the impact of TST as an independent predictor variable of children's VMI and bilateral coordination skills (p<.23 and p<.61). Playing with toys and using object substitution in play (e.g. a child uses an object for something else other than its intended use when playing with it) potentially appear to be a moderating factor of the impact of children's screen-time on their bilateral coordination and VMI skills. Clinicians can encourage children's active and dynamic involvement in games and play pursuits to counteract the potential impact of increased use of devices that involve screen-time.