Child Care Research Articles

Peer socialization processes in the development of callous-unemotional traits.

Callous-unemotional (CU) traits represent a risk factor for persistent, severe levels of externalizing problems. Irritability may predict the development of CU traits for some individuals, who are thought to acquire them in reaction to negative environmental experiences. Models on the development of CU traits have emphasized the socializing role of harsh parenting to the neglect of negative peer experiences. The present study 1) tested primary and alternative models of physical and relational peer victimization as socialization agents in relations between irritability and CU traits; and 2) considered hypothalamic-pituitary-adrenal-axis functioning as a moderator of these associations. Gender moderation was also considered. Aims were tested from middle childhood to adolescence using data from the NICHD Study of Early Child Care and Youth Development, which includes a large national sample (N = 1,077) and multiple methods and informants for the constructs of interest. Positive associations between irritability, peer victimization, and CU traits were supported, with indirect effects on CU traits supported specifically from peer victimization through increases in irritability. Associations between relational victimization, irritability, and CU traits may be particularly salient for females, whose experiences have been neglected to date. However, effects were small, and replication efforts are needed.

Suicide Prevention and Telehealth in Children's Hospital Emergency Departments.

Suicide is a leading cause of death among adolescents. Emergency department (ED) visits for mental health concerns are rising, and telehealth is increasingly used to provide emergency mental health care. We conducted a national survey to describe suicide prevention practices and tele-mental health care in children's hospital EDs. We conducted a cross-sectional survey of leaders at all 52 US EDs affiliated with dedicated children's hospitals (ie, hospitals that provide care only to children) to describe use of tele-mental health care and suicide prevention practices. Leaders from 41 EDs completed the survey (79% response rate). Tele-mental health care was used in 23 EDs (56%); there were no differences in ED structural characteristics between institutions with telehealth versus without telehealth. Among responding EDs, 40 (98%) reported they screen for suicide risk, and 29 (71%) reported they use a standardized approach to suicide prevention discharge planning. Risk reduction practices conducted at many but not all EDs included assessment of access to lethal means (n = 31, 86%), counseling on reduction of access to lethal means (n = 30, 73%) and providing patients with a list of professionals or agencies that they can contact in a crisis (n = 35, 85%). There were no differences in use of suicide prevention practices at EDs with versus without telehealth (P > 0.1 for all). Approximately half of children's hospital EDs use tele-mental health care, and hospitals with versus without tele-mental health care report similar rates of suicide prevention practice use. Opportunities exist to increase use of discharge safety practices.

Multifaceted Treatment and Therapies in the Care of Children with Cerebral Palsy – A Literature Review

Introduction and Purpose: Cerebral palsy (CP) is a prevalent neurological disorder in children, characterized by movement, muscle tone, and posture impairments. This article reviews the clinical and therapeutic management of CP, focusing on spasticity, musculoskeletal disorders, and holistic rehabilitation. It examines evidence-based interventions, including onabotulinumtoxinA, intrathecal baclofen pumps, and surgical options for orthopedic deformities. Key rehabilitation techniques such as neurodevelopmental therapies, gait training, and speech therapy are discussed to enhance motor skills and cognitive development. Additionally, the management of associated conditions like epilepsy and intellectual challenges is addressed, emphasizing psychological support for patients and families. The purpose of this article is to provide a comprehensive overview of the current state of knowledge regarding the management of cerebral palsy. Material and Methods: We utilized English databases such as PubMed, Google Scholar, Cochrane, and PubMed Central, selecting articles based on keywords like cerebral palsy, spasticity, physical therapy, and rehabilitation. State of Knowledge: Effective CP management requires a multidisciplinary approach to tackle motor impairments, spasticity, deformities, and psychosocial challenges. Therapeutic interventions, including pharmacological treatments, surgical options, and innovative rehabilitation techniques, are essential for improving mobility and quality of life. Summary: Comprehensive care for children with CP is crucial. Evidence supports combining multiple therapeutic approaches tailored to each child’s needs and involving family preferences to optimize development and well-being.

Informing peer support programs for active duty military spouses of U.S. Army soldiers

LAY SUMMARY With 50% of active duty service members being married, spouses are critical in supporting military readiness. Yet, because of the nature of military service, spouses experience numerous challenges, including education and career progression, parenting and child care, managing family separation during deployment and training, and accessibility of health care. Peer support programs can develop a sense of community, provide support for shared challenges, and offer access to resources. Building on a peer support program with Veteran spouses, this study identified the challenges and needs of active duty spouses to inform adaptation of the program. Five focus groups were conducted on Zoom with 35 active duty military spouses to understand their main concerns and preferences for a peer support program. Major themes identified were challenges of military life, benefits of military life, and recommendations for peer support programming. This study’s findings will be used to adapt and develop a peer support program to be tested with military spouses of U.S. Army soldiers in a study funded by the U.S. Department of Defense.

Pediatric Emergency Medicine Physicians' Perspectives of Concussion in Young Children.

Traumatic brain injury (TBI) during early childhood (before 6 years) is prevalent, accounting for rising rates of emergency department visits. These injuries may lead to postconcussive symptoms, which may be subtle and difficult to diagnose in young children. Inadequate discharge counseling may lead to prolonged duration of symptoms and possible developmental delays. We aimed to explore pediatric emergency medicine (PEM) physicians' perspectives on "concussion" terminology, diagnosis, and management, specifically in a young child with mild TBI. We conducted semistructured interviews using open-ended questions involving a hypothetical scenario. We recruited currently practicing PEM physicians by a snowball sampling method. A research team recorded, transcribed, and analyzed the interviews. Using social constructionism as the philosophical framework, we developed and refined codes and derived themes until reaching thematic saturation. Peer debriefing with an expert collaborator aided with revisions of themes. A single PEM researcher interviewed 13 participants. Three primary themes emerged. Our first theme identified the role of guidelines and tools in the diagnostic workup. Most participants utilized a clinical prediction tool for neuroimaging but no clinical symptom scales. Our second theme described the difficulties and inconsistencies in the approach to diagnosis of concussion, largely due to young age, lack of verbal skills and unreliable examinations. Our last theme focused on the difficulty in providing clear discharge instructions to parents. Many participants described difficulty providing activity restrictions, instead allowing self-modulation, and lack of counseling for educational tasks. Variability exists among PEM physicians in diagnosis and management of concussions in young children. Discomfort with lack of reliability of symptoms and underappreciation of typical early childhood characteristics may account for findings. Educational initiatives, age-appropriate clinical tools and treatment-guided outcomes research are needed to guide PEM physicians in the care of young children with head injuries.

PERAN ORANG TUA DALAM PENGEMBANGAN SOSIAL EMOSIONAL ANAK DI ERA SOCIETY 5.0

The Society 5.0 era is a concept of a human-centered and technology-based Society , where early childhood is also very close to technology, especially gadgets. This has more or less affected the social emotional development of early childhood. This study aims to determine the role of parents in the development of children's social emotional aspects in the Society 5.0 era and to determine the social emotional aspects of children in the Society 5.0 era using a qualitative descriptive approach to parents who have children aged 4-5 years. Data collection techniques with interviews and observations. The role of parents in the Society 5.0 era has a very influential role in children, differences in children's behavior were found when using technology and their social emotions in parents who play a direct role in children and parents who work and the social emotional aspects of children are currently influenced by the Society 5.0 era which makes children dependent on gadgets so that children are more comfortable alone with gadgets which has an impact on minimal interaction and socializing children with others. The role of parents is very influential in the social emotional development of early childhood, therefore the need for care and guidance for children.

Resilience of unaccompanied refugee children in foster care at Tongogara Refugee Camp Zimbabwe

This article explores and discusses the resilience of refugee children under foster care in Zimbabwe. It advances the argument that there are resilience factors associated with unaccompanied refugee children under the foster care programme at the Tongogara Refugee Camp. Data were gathered using an exploratory qualitative research design using document analyses, 10 refugee children under foster care and 10 key informant interviews, which were conducted to gain a deeper understanding of the lives of refugee children under foster care at the Tongogara Refugee Camp. Evidence from the sources shows that there are several factors enhancing resilience among unaccompanied minors in foster care, such as religious, personal and macro support from foster parents, agencies involved in childcare, and educational support. It is recommended that the National Orphan Care Policy of 1999 be reviewed and the provisions of social protection programmes for unaccompanied refugee children under foster care be strengthened.

Paternal incarceration, child care instability, and children's wellbeing

AbstractObjectiveThis study examines the relationship between paternal incarceration, child care instability, and children's well‐being.BackgroundDespite the established repercussions of paternal incarceration for children and families, little is known about how paternal incarceration is associated with child care arrangements and how unstable child care arrangements moderate the deleterious consequences of paternal incarceration for children's well‐being.MethodsWe use data from the Future of Families and Child Wellbeing Study, a cohort of urban children born around the turn of the 21st century, to examine the relationship between recent first‐time paternal incarceration and child care instability (measured by long‐term instability, multiplicity, and back‐up care arrangements). We also examine how child care instability moderates the relationship between recent first‐time paternal incarceration and children's problem behaviors.ResultsAnalyses suggest three main findings. First, paternal incarceration is positively associated with long‐term child care instability, net of prior instability and factors associated with selection into paternal incarceration. Paternal incarceration is not associated with multiplicity or back‐up care. Second, the relationship between paternal incarceration and children's problem behaviors is larger among children with unstable care arrangements than among those with stable care arrangements. Third, children living with their father prior to his incarceration, compared to children not living with their father prior to his incarceration, experience larger consequences of paternal incarceration.ConclusionWe document the relationship between paternal incarceration and child care instability and how this instability moderates the association between paternal incarceration and children's problem behaviors.

Using vignettes to compare the views of social workers and service-users: Some findings and reflections regarding assessments in child welfare

While vignette studies have become more prevalent in social work research, it is, however, uncommon to include both practitioners and service-users in the research design to provide their views on an identical case. In this article, the aim is both to reflect on the usefulness of the vignette method in exploring assessments of the needs for services from the points of view of practitioners and service-users and to explore empirically those views on an identical case. The article is built on 28 group interviews with 120 practitioners and 14 group interviews with 41 care-experienced young people and parents of children in care. There are considerable similarities across the groups in their emphasis on ‘more information’ but the groups of practitioners and service-users also differ in their views on the nature of required information (what vs. why) and the purpose of the assessment (intake vs. solving problems). The analysis highlights some mundane manifestations of the implications of recent reforms in family and child welfare services in Finland, and most importantly, the ethical potential which the inclusion of both service-users and practitioners in the vignette design entails.

Factors influencing concurrent wasting, stunting, and underweight among children under five who suffered from severe acute malnutrition in low- and middle-income countries: a systematic review

BackgroundWasting, stunting, and underweight in children are complex health challenges shaped by a combination of immediate, underlying, and systemic factors. Even though copious data demonstrates that the causation routes for stunting and wasting are similar, little is known about the correlations between the diseases in low- and middle-income nations.ObjectiveThe objective of this study is to evaluate the factors that concurrently affect wasting, stunting, and underweight in <5-year-olds with severe acute malnutrition (SAM).MethodThis review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched every electronic database that was available, from the medRxiv pre-print site, PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, PsycINFO, CINAHL, Google Scholar, and Scopus, in addition to the Science Direct search engine. We considered research conducted in low- and middle-income nations on <5-year-olds with SAM. The Newcastle Ottawa Scale was used to assess the quality of the studies.ResultsAfter screening and selecting 12 eligible studies, 1,434,207 records were included for analysis. The prevalence of factors influencing concurrent wasting, stunting, and being underweight was 26.42% in low-middle -income countries (LMI). The prevalence was higher in men, with wasting, stunting, and underweight at 14.2, 4.1, and 27.6%, respectively. Unprotected drinking water was associated with stunting [odds ratio = 0.68; 95CI (0.50, 0.92)]. Being male is another factor (aOR = 2.04, 95% CI: 1.13, 3.68). Lack of prenatal care follow-up was associated with a lower risk of wasting (OR = 2.20, 95% CI: 1.04, 4.64), while low birth weight (<2.5 kg), diarrhea, having a younger child, and being from a poor household were associated with wasting, stunting, and underweight. Other factors included body mass index (BMI) for age aOR = 2.11, 95% CI: (0.07, 0.895); maternal education: stunting [aOR = 1.52, 95% CI: (0.09, 0.89)], underweight [aOR = 1.97, 95% CI: (0.01, 0.73)], and open defecation, stunting [aOR = 1.62, 95% CI: (0.06, 0.32)], underweight [aOR = 1.92, 95% CI: (0.042, 0.257)]). Likelihood of being underweight increased with birth order (second born, aOR = 1.92, 95% CI 1.09–3.36; third born, aOR = 6.77, 95% CI 2.00–22.82).ConclusionInadequate dietary intake, illness, food insecurity, poor maternal and child care, poor hygiene and sanitation, and healthcare inaccessibility contribute to SAM.

Transition of care: toward tailored transition of adolescents with osteoporosis and metabolic bone diseases to adult care through an integrated, people-centered, disease-specific health services framework

BackgroundThe Egyptian Academy of Bone and Muscle Health in collaboration with the Egyptian College of Pediatric Rheumatology have identified two indicators to ensure optimum health outcomes among children: one is developmentally and nutritionally appropriate healthcare, and the second is the availability of an effective transition of care model from pediatric care to adult health services. Currently, there is no national guidelines on transition of care for children and adolescents with osteoporosis and metabolic bone disease. To close this gap, this work was carried out to develop the Egyptian guidelines for transition model of care.ResultsThe final recommendation included 12 specific domains. These included the following: targeted population, transition age, transition readiness, patient-targeted care, and disease-specific knowledge, patient education, and optimum model for the transition of care, transition referral, management approach, high quality of care, documentation, and recent service approaches as well as standards and quality indicators. All the overarching principles and most voters agreed with the 12 amended recommendations.ConclusionTransitional care is the term used to describe services that seek to bridge this care gap. Based on the best available data and professional judgment, these consensus-based recommendations guide ways to achieve optimal outcomes in transitional care for adolescents with osteoporosis and metabolic bone disorders. Though focussed on transition of care of bone and muscle health, this article can be the bases for transition services for children with other chronic conditions. This could be used as a blueprint for additional national or internationally healthcare transition policies.

Evaluation of a pediatric navigation program within primary care: a quantitative analysis guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework

BackgroundPediatric Support Services (PSS) is a Patient Navigation Program designed to address barriers from referral-to-service connection from primary care to health system and community-based services and resources. This study aimed to evaluate PSS’ implementation for mental health services along the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and identify factors throughout implementation to inform sustainability and delivery.MethodsThis study included descriptive analysis of all patients referred to PSS to assess reach, with a primary cohort analyses of a subset of patients referred specifically to mental health services. Data collection included triangulation of information extracted from electronic health records, direct contact with patients’ caregivers, and follow-up surveys completed by patients’ caregivers. Analyses were designed within each construct of the RE-AIM framework, and assessed for their tiered impact on the patient, provider, and system levels.ResultsFrom October 2019 to June 2023, 13,109 total referrals for 11,214 unique patients were triaged by PSS. The patient population overrepresented younger, Hispanic, female patients compared to the clinical population included in this health system’s service area. Of these patients, 3,929 were followed-up by trained navigators at two-weeks for mental health service connection, with 50.6% reported being connected to referred services and an additional 27.1% with pending appointments. There was a significant increase in referral connection rate as age increased and for Black patients, compared to other children. For patients considered connected to or pending services, a satisfaction survey found high satisfaction with PSS and the amount of navigator-patient contact (81.5 and 79.6%, respectively).ConclusionThese findings highlight potential program modifications to optimize quality of care and health for children and families, while enhancing capacity among providers, navigators, and clinics. Further adaptations, including electronic health record integration, patient/family feedback, and automated navigation processes, are suggested next steps for comprehensive navigation.Trial registrationThis study was approved by the Institutional Review Board for Prisma Health, trial number 1,852,794, with the most recent approval for expanded evaluation received on June 15, 2022 (original application approved in 2016).

Bias and Discrimination Against Women and Parents in Semi‐Automated Hiring Systems

ABSTRACTToday, organizations are increasingly relying on automated hiring. The mechanization of the hiring process is assumed to render it more neutral, but a growing literature shows algorithmic decisions are as likely to be biased (Dickson, 2018). In this study, we test two types of biases: (1) gender bias; and (2) parenting bias, (i.e., whether mothers and fathers with an extended gap to care for children are penalized vis‐à‐vis those with uninterrupted employment net of equivalent high‐impact qualifications). We apply a classic counterfactual study sending gender and parenthood manipulated CVs to 211 job advertisements across three occupations (men‐dominated, women‐dominated, and gender‐balanced, to mitigate confounding variables associated with gender composition) in the United States and measure penalty‐premium bias in response rates. Our results identify semi‐automated hiring bias against parents who took leave to care for children relative to those with uninterrupted employment. Importantly, we find fathers who have an extended parental leave were the most severely penalized, followed by mothers with an extended parental leave and women and men without parental leave respectively. Ultimately, we identify gender and parenting bias in algorithmic and human hiring decisions.

Differential roles of problematic media use by mothers and toddlers in the relation between parenting stress and toddlers’ socioemotional development

The increasing prevalence of digital media devices in families with young children has raised concerns over problematic media use. However, the link between toddlers’ problematic media use, their socioemotional development, and the influence of parental factors remains unclear. The current study examined the roles of problematic media use by both mothers and toddlers in the association between maternal parenting stress and toddlers’ socioemotional development. Participants comprised 215 mothers and 73 lead child care classroom teachers of toddlers aged 24–36 months enrolled in child care centers in South Korea. Mothers reported parenting stress and problematic media use by themselves and their toddlers, and child care teachers reported toddlers’ socioemotional development. The results from structural equation modeling analysis revealed that maternal parenting stress was related to toddlers’ socioemotional development both directly and indirectly through toddlers’ problematic media use, both alone and in conjunction with mothers’ problematic media use. Although maternal parenting stress was related to mothers’ problematic media use, mothers’ problematic media use was not directly related to toddlers’ socioemotional development. These findings underscore the importance of toddlers’ problematic media use in their socioemotional development and highlight the need for comprehensive approaches that address family dynamics, such as maternal parenting stress and problematic media use.

Helping Special Needs Children to Make Friends

Introduction: Children with special needs are often considered to be cursed. They are frequently ostracized from society thus making them feel lonely. This paper aims to help patients, especially children with special needs, find good friends through the review of current studies. Methods: This study used a descriptive quantitative method and data that was retrieved from Child and Adolescence Psychiatric Outpatients Daycare, Dr. Soetomo General Academic Hospital, Surabaya with 80 children with ADHD and 160 children with ASD. Results: A common intervention used in Indonesia is applied behavior analysis (ABA), a method that trains children to have social skills such as how to communicate, interact, and express themselves in social settings. Besides personal intervention, the need for integrated care for children with special needs such as pharmacological therapy, speech and behavioral therapy, occupational therapy, and special education, is needed to support them in helping them make friends. Conclusion: To help children with special needs make friends, we can give support, appreciation, and motivation. However, children with special needs need different treatment from their peers, so special attention and understanding are needed so that children with special needs can socialize and make friends well. Keywords: Children, Special Needs, Friends, Mental Health, Loneliness

Challenges of Parenting in the Digital Era: A Review from the Perspective of Islamic Family Law

This study examines the challenges of child-rearing within Muslim families in the digital era, focusing specifically on the perspective of Islamic family law. The research addresses Muslim parents' complex issues in adapting Islamic family law principles to parenting practices compatible with digital realities. The study aims to identify significant challenges encountered in digital parenting and to propose relevant legal recommendations to support Muslim families. Using a qualitative approach with data collection techniques such as in-depth interviews, observations, and focus group discussions, the study involved 30 Muslim families, Islamic scholars, and legal experts. The findings reveal that critical challenges include difficulties in the digital supervision of children, low digital literacy among parents, and value conflicts between Islam and digital culture. The study highlights the need for supportive legal adaptations that preserve Islamic character education within the digital context, helping safeguard children's ethics and morals. Effective strategies include balanced surveillance technology aligning with Islamic values and implementing digital use guidelines. The study's implications emphasize the importance of collaboration among legal experts, policymakers, and stakeholders to establish a responsive legal framework addressing digital challenges and supporting Muslim families in integrating child-rearing with religious teachings.

Work-Life Balance and Employee Performance in Selected Deposit Money Banks in Delta State, Nigeria

This study examined the effect of work-life balance on employee performance among staff of selected deposit money banks in Delta State, Nigeria. The specific objectives of the study were to ascertain the effect of the measures of work-life balance, namely; flexi-time schedules, family leave programs, child care facilities, and job sharing on the employee performance. Survey research design was adopted in this study. The total population of the study was 2,083 employees from nine selected banks which comprise of staff of the banks under study. The Taro Yamane formula was used to draw a sample size of 336 employees. The primary data used in this study were collected through the aid of five point-likert scale structured questionnaire. A total of three hundred and thirty-six (336) copies of questionnaire were administered to staff of selected deposit money banks in Delta State. However, three hundred and nineteen (319) were retrieved and properly filled. The responses were analyzed using descriptive statistics, correlation and multiple regressions with the aid of SPSS version 23. The findings revealed that the four dimensions of work-life balance have positive significant effect on employee performance. The study concluded that work-life balance is a strong determinant employee performance in deposit money banks in Delta State, Nigeria. The study recommended that more flexi-time schedules be made available to all employees, provided it will not affect their performance. Also, managers of these banks should encourage their employees to fix their leave at their convenient period after performing all their work related duties. In order to achieve a successful work-life balance, management should provide a conducive work environment and flexible work hours as well as consider job sharing options.

Mental disorder diagnoses and symptoms and functional impairment in school-age children in the care of child protective services

BackgroundAbout 50 % of children in the care of child protective services present at least one mental disorder, but few studies have looked at whether there are differences in mental disorders or symptoms between children placed in out-of-home care (foster care and residential care) and their community peers. ObjectiveThis study documents the mental disorder diagnoses and symptoms among children in out-of-home care and their associations with children functional impairment. It also compares out-of-home care children with those from the community. Participants and settingThe sample was composed of children aged 5 to 12 years in foster care (n = 154), in residential care (n = 111), and from the community (n = 92). MethodsCaregivers reported the children's diagnoses and completed questionnaires on the children's symptoms. Results1) Proportionally more children in out-of-home care presented a mental disorder than did children from the community. Proportions were similar for those in foster care and those in residential care; 2) Children in out-of-home care presented more symptoms than those from the community for all the mental disorders considered and the children in residential care presented more symptoms than did those in foster care for about half of the disorders considered; 3) symptoms were strongly associated with functional impairment; and 4) the symptoms of RAD, ADHD, OCD, CD, and ODD proved significant predictors of functional impairment. ConclusionsThis study provides a picture of the mental disorders and symptoms among samples of school-age children in the care of child protective services and raises questions about the proportions of some of the diagnosis that children receive.

Two service evaluations of LEAPlets – An early years programme for children in foster care and adoption, based on the BUSS® (Building Underdeveloped Sensorimotor Systems) Model

BUSS® is a relationally based intervention, bringing an appreciation of the role nurture, touch and movement play in the development of bodily regulation in early childhood. Following a neurosequential understanding of development ( Perry and Hambrick, 2008 ), BUSS® works to support foster carers and adoptive parents in understanding both the disruptive impact of trauma on the development of their child’s foundation sensorimotor systems and the critical role they can play in ameliorating this disruption. Good bodily regulation offers children a platform upon which relationships, emotional regulation and learning can grow ( Lloyd, 2023 ). LEAPlets is a group for children and their parents and carers, based on the BUSS® Model. It aims to build attachment relationships, supporting parents and carers in understanding and rebuilding their child’s foundation sensorimotor systems. This paper brings together two service evaluation projects of LEAPlets carried out by clinical psychologists in training. The first evaluation is of LEAPlets as a school readiness programme for children in foster care in Leeds. The second evaluation is the LEAPlets group in One Adoption West Yorkshire (OAWY) for new adoptive parents and their newly adopted children. While more research is needed, both studies showed improvements for the children in bodily and emotional regulation, communication and relationships, as well as positive changes in skill development, understanding of their child, and relationships for foster carers and adoptive parents. Models like LEAPlets, which address both the relational and sensorimotor consequences of early trauma, may usefully form part of early intervention programmes for care-experienced children. Training to run LEAPlets groups has been developed, and groups are now running in England, Wales and the Republic of Ireland. This will be explored and discussed, with reference to school readiness, impact on foster carers and supporting adoptive families early in their life together.

A longitudinal study of the role of fingers in the development of early number and arithmetic skills in children with Apert syndrome.

This paper discusses a longitudinal study with children with Apert syndrome aged between 4 and 11 years. There has long been an interest in the role of fingers in the development of early number skills and arithmetic. As children with Apert syndrome are born with complex fusions of their fingers, they have to undergo several surgical procedures in order to obtain individuated fingers. This has implications for their finger mobility and finger awareness. It has been suggested that children with Apert syndrome have specific difficulties with early number and arithmetic activities. The findings from this study suggest that engaging children with Apert syndrome in activities that develop finger awareness (finger gnosis) and finger mobility (fine motor skills) may have a positive impact on their ability to engage with appropriate mathematics curricula at school. This is relevant to all those involved in the care of children with Apert syndrome and will be of particular relevance to those involved in early childhood and primary education. This study also provides new insights into the role of finger use in the development of skills and understanding in early number and arithmetic.