Children's Access Research Articles

Elicitation of children's understanding of information in pediatric genetic counseling encounters: A discourse-oriented perspective.

Affirmation of children's understanding of information provided in genetic counseling encounters is crucial to obtaining children's informed consent/assent in pediatric genetic counseling encounters. It is also important for the proper management of a genetic condition. Currently, there is a relative scarcity of research on how understanding of complex genetic information by children is elicited in the process of pediatric genetic counseling. In this study, we apply theme-oriented discourse analysis to examine 23 video/audio-recorded genetic counseling encounters in Hong Kong. The encounters involve children aged between 3 and 17years old who are suspected to have or diagnosed with Sudden Arrhythmic Death Syndrome (SADS). Specifically, we examine a range of communicative strategies that genetic professionals employ to elicit children's understanding of information in this genetic counseling setting. We also examine how children's epistemic status is negotiated between genetic professionals, parents, and children. The study reveals that genetic professionals typically use direct questioning (e.g., "do you understand?" or "do you have any questions?"). Less typical are examples where genetic professionals explore children's epistemic access and invite children to recall information after they deliver it. The study reveals two discourse strategies that genetic professionals and parents employ to justify a child's low epistemic status: (1) construction of "current ignorance" and "future competence" in children and (2) association with a child's character. In the examined counseling encounters, genetic professionals and parents tend to construct a low epistemic status in younger children and allocate the responsibility for understanding relevant information to the parents and the "future" competent children. The study highlights the impact of genetic professionals' and parents' assumptions on children's knowledge and comprehensibility at different ages, and the role that children themselves play in conforming or contesting these assumptions.

Medicaid and Child Health Insurance Program Improve Child Health and Reduce Poverty But Face Threats.

Over the past 20 years, the United States greatly expanded eligibility for public health insurance under the Medicaid and Child Health Insurance Program programs. This expansion improved children's access to health care and their health, ultimately lowering preventable hospitalizations, chronic conditions, and mortality rates in the most vulnerable children at a cost that is 4 times lower than the average per capita cost for the elderly. They also had broader antipoverty effects, increasing economic security, children's educational attainments, and their eventual employment and earnings opportunities. However, in recent years, this progress has been rolled back in many states. Remarkably, although income eligibility cutoffs have remained largely constant, states have reduced child coverage through a number of administrative measures ranging from increased paperwork, to reduced outreach, new parental work requirements, changes to public charge rules for immigrants, and waivers of federal requirements to provide retroactive coverage to new applicants. The number of uninsured children was rising for the first time in decades even prior to the pandemic. With rising numbers who have lost their jobs in the pandemic-induced recession, it is more important than ever to defend and restore and improve access to public health insurance for our children.

Ultra-processed foods in childhood: a system of violation of rights and food and nutrition insecurity

Discussions on the health consequences of the consumption of ultra-processed foods (UPFs) are wide-ranging, but little has been addressed under systemic aspects, human rights, sovereignty and food and nutrition security, and socio-environmental sustainability. For this reason, the aim of this article was to analyze the systemic implications of children's access to UPFs. Secondary data from a cross-sectional survey conducted with pre-school students of two private schools in a capital city in the Northeastern region of Brazil were analyzed through the analysis of lunch boxes for three consecutive days. The most frequent UPFs had information about the manufacturing location, ingredients, and brand collected from their labels and subsequently studied. We noticed that most of the products were manufactured in other states, being transported for long distances, had little ingredient diversity, and belonged to sub-brands that conglomerate into “big players”. In this sense, we conclude that children are having their right to food violated and that access to UPFs by this public supports a hegemonic and unsustainable food system from a socio-environmental point of view that contributes to food and nutrition insecurity.

Supporting youth mental health during the COVID-19 pandemic.

Supporting youth mental health during the COVID-19 pandemic.

Semiprivate space and access to online education during COVID-19: empirical tests from China

PurposeAlthough the use of online technology has generated excitement over its potential to increase access to education, most existing research has focused on comparing online and in-person student performance. This study provides empirical evidence that semiprivate space at the family level affects students' access to online education.Design/methodology/approachStudents from 1,565 low-income households in China were surveyed, and a multivariate logistic regression analysis was conducted on the hypothesized factors that affect access to online education at home.FindingsThe results show that the absence of computers, smartphones and broadband networks at home severely hinders children's access to online education, and even leads to their exclusion from it. Children with their fathers or paternal grandfathers as guardians have a lower probability of receiving online education at home. It was also found that the higher the education level of the head of the household, the more likely it is that children will receive online education at home.Originality/valueThis study is one of the first to examine online accessibility at the family level. It also demonstrates that the semiprivate space at the family level may limit opportunities for students who would otherwise pursue online education at home.

The Relationship Between States' Immigrant-Related Policies and Access to Health Care Among Children of Immigrants.

States vary in their participation in federal immigration enforcement, leading to differing state-level policy contexts that profoundly shape the lives of immigrants. This paper examines the effects of sanctuary policies and driver’s licenses for undocumented immigrants on immigrants’ children’s access to preventative healthcare. The 2008–2016 Medical Panel Expenditure Survey merged with state-level policy data were analyzed using a difference-in-difference OLS regression. Outcome variables included whether the child had a usual source of care, any unmet medical needs, or a well child check-up. State driver’s license and sanctuary policies were associated with having a usual source of care and fewer unmet medical needs among children of immigrants. The recent pandemic highlights the importance of access to preventative health care. State policies that limit federal immigration enforcement involvement are associated with improved access to preventative health services among immigrants’ children, most of whom are U.S. citizens.

Potential engineers: A systematic literature review exploring Black children's access to and experiences with STEM

AbstractBackgroundAs engineering remains central to the US economy, it is imperative that the innovators of this field reflect the world in which we live. Despite decades of concerted effort to broaden participation in engineering, representation continues to lack.PurposeThe purpose of this paper is to provide education researchers and practitioners with a clear understanding of barriers to the participation of Black American children in science, technology, engineering, and mathematics (STEM). Our interest is driven by the role that precollege STEM experiences play in children's likelihood of becoming potential engineering students.Scope/MethodWe conducted a systematic literature review of 41 articles focused on Black children in precollege STEM contexts. Each article underwent individual review to gain deeper insight into key contextual factors that enable and constrain these potential engineers.ResultsWe situate our research findings in Perna's college choice model to highlight the key factors that may influence one's career and college decisions. The contextual factors are associated with the (1) social, economic, and policy context (e.g., racism, sexism, and classism); (2) STEM educational and community context (i.e., social perceptions and access); and (3) the local support context (i.e., teachers and family).ConclusionsOur results represent the early workings of a “glass ceiling” above the heads of potential engineering students. The underrepresentation of Black Americans who thrive in engineering is a byproduct of the lack of accessibility to quality and advanced learning experiences that too often plague K–12 schools and communities that serve high populations of Black Americans. Such findings have implications for research and practice.

Heterogenous parental responses to education quality

ABSTRACT Are parental inputs complements or substitutes to education quality? Using variation induced by identification into a gifted and talented (GT) program, I find no aggregate effects on parental behavior as a result of their child's access to a higher quality education. However, there are heterogeneous effects. Non-minority parents decrease engagement but increase tutoring. Minority and low-income parents increase engagement and increase both tutoring and in-home homework help. Results suggest that parental investments are not necessarily a strict complement or substitute but is nuanced dependent on demographic factors. I provide suggestive evidence that the primary mechanism is parental beliefs.

The Impact of Restrictive Policies on Mexican Immigrant Parents and Their Children's Access to Health Care.

Background: This study assessed whether policies that limit Mexican immigrants' access to care affects their children's access to a regular source of care, health insurance, and timely preventive health visits.Method: This was a cross-sectional study among Mexican immigrant parents who attended a health promotion program in Texas, Nevada, New York, and Illinois. A sociodemographic survey, including parental and child variables, was administered.Results: Children of parents without health insurance were almost four times more likely to be uninsured and eight times more likely to lack a regular source of care. Children of parents without a regular source of care were less than half as likely to have their own regular source of care than children whose parents had a regular source of care.Discussion: Findings suggest when parents are uninsured/lack a regular source of care, a child's health disparity is created. Reducing disparities in health care coverage, affecting foreign-born parents, positively impacts their children's access to care.Clinical Trial Registration number: NCT03209713.

When parents are not present: Decision-making dynamics for young children's health and illness in migrant-sending households in rural Cambodia

As migration rates increase globally, an increasing proportion of children in low- and middle-income countries live apart from their parents. In particular, skipped-generation households are becoming more common, with grandparents serving as primary caregivers for young grandchildren whose parents migrate and provide remittance support. Yet, how families living apart make decisions for young children's healthcare is not well understood. Processes of care seeking for children's health are examined in Cambodia, which has high rates of internal and international migration, and an increasing number of skipped-generation households. We conducted semi-structured in-depth interviews with grandparents who are primary caregivers for children under ten in skipped-generation households in rural migrant-sending areas. Respondents discussed their family's migration history, care seeking and decision making for grandchildren, dynamics with absent migrant parents, and sources of support. Decisions for children's care are intimately tied to the availability of migrant remittances, which are the modality of the relationship between grandparents and parents. Additional remittance support allows grandparents to make decisions for grandchildren's health based on convenience rather than cost, given the burdens of caring grandparents have taken on a result of the parent's migration. Instrumental supports such as in-kind assistance and informational supports further facilitated children's access to healthcare. This qualitative study informs and explains findings from recent quantitative studies of migration and child health.

Global estimates of the implications of COVID-19-related preprimary school closures for children's instructional access, development, learning, and economic wellbeing.

Observational data collected prior to the pandemic (between 2004 and 2019) were used to simulate the potential consequences of early childhood care and education (ECCE) service closures on the estimated 167 million preprimary‐age children in 196 countries who lost ECCE access between March 2020 and February 2021. COVID‐19‐related ECCE disruptions were estimated to result in 19.01 billion person‐days of ECCE instruction lost, 10.75 million additional children falling “off track” in their early development, 14.18 million grades of learning lost by adolescence, and a present discounted value of USD 308.02 billion of earnings lost in adulthood. Further burdens associated with ongoing closures were also forecasted. Projected developmental and learning losses were concentrated in low‐ and lower middle‐income countries, likely exacerbating long‐standing global inequities.

Events structure information accessibility less in children than adults

To manage the onslaught of continuously unfolding information in our complex environments, we adults are known to carve up our continuous experience into meaningful events, a process referred to as event segmentation. This segmentation directly shapes how our everyday experiences are construed: content experienced within an event is held mentally in an accessible state, which is then dropped after an event boundary. The greater accessibility of event-specific information has been shown to influence—at its most basic level—how information is processed and remembered. However, it is as yet unknown if accessibility is similarly influenced by event boundaries in children, who are still developing the working memory capacity and semantic knowledge thought to support event segmentation. Here, we tested seven- to nine-year-old children's and adults' recognition of objects experienced either within or across event boundaries of two cartoons. We found that children and adults were both more accurate and faster to correctly recognize objects that last occurred within events versus across event boundaries. We, however, additionally observed an interaction such that children's access to recent experience was less influenced by event boundaries than adults'. Thus, while the spontaneous segmentation of complex events emerges by middle childhood, event structure shapes the active contents of children's minds less reliably than adults'.

The Affordable Care Act, COVID-19, and Health Care Insurance for Children.

Despite numerous legal and political challenges over the past decade, the Patient Protection and Affordable Care Act (ACA; Library of Congress, 2010) has been integrated into the health system of the United States and has played an important role in improving child health in this country by increasing access to health care for millions of children. The ACA has also provided a health care lifeline to children and families during the coronavirus disease 2019 (COVID-19) pandemic. This policy brief reviews the legal status of the ACA, explores the impact of COVID-19 on children's access to health insurance, discusses recent legislation supporting child health, and considers the future status of child health insurance coverage and access to care.

An exploratory case study: children’s comparative play access in English and Welsh classrooms

ABSTRACT The United Nations Convention on the Rights of the Child (1989) stipulates children's right to play. General Comment No. 17 (2013) also emphasises the importance of play as a medium for learning. This comparative case study explored children's experiences of accessing play through curriculum delivery in two United Kingdom countries, England and Wales, where curricula place comparative emphasis on play. The study used observations of sixteen five- to seven-year-olds and interviews with two teachers. Both teachers valued play for enjoyment and engagement, and reflected on the experiences and beliefs impacting their teaching. Implications are discussed in relation to factors that facilitate or inhibit children's access to play within curricula. The study calls for further research on the impact of recent Welsh policy and legislation on children's opportunities for play in school, and what could be learnt from this in terms of pedagogy and playfulness in an English or other context.

P73 Cultivating Connections with Farm to School Activities During School Closures

<h3>Objective</h3> To engage youth and their families in a web-based hybrid club for farm to school activities as an alternative to school-based activities when schools closed due to the pandemic. <h3>Use of Theory or Research</h3> Farm to school programs increase children's access to and knowledge of fresh and local foods primarily through experiential learning (Kolb's Experiential Learning Theory) such as gardening, tasting food and field trips. <h3>Target Audience</h3> Youth, grades 2-6, and their families who experienced disruption in usual learning and social activities due to COVID-19 restrictions. <h3>Program Description</h3> Experiential activities are the hallmark of farm to school education. In March 2020 all hands-on, school based activities planned by Extension faculty were cancelled due to the pandemic. Faculty responded by offering garden-cooking clubs using a web-based hybrid approach independent of schools. Faculty facilitated bi-weekly virtual meetings of 30 minutes for 6-8 weeks for youth and their families. Asynchronous activities were also offered via a website, kits, video demonstrations, farmers market vouchers and when possible, farm tours. <h3>Evaluation Methods</h3> Adult caregivers received a survey at the end of the 6-8 week club sessions to evaluate their child's and family's level of engagement including queries on how much time they spent using web-based tools and how likely they were to start a garden. <h3>Results</h3> One hundred and ninety youth, grades 2-6, and their families participated in 4 virtual and/or hybrid clubs delivered by Extension faculty from March 2020 to October 2020. Caregiver responses from the survey (n = 46) indicated 83% of families expanded or started a garden. On average youth and/or families spent 47 minutes per week engaged in program activities including online learning. <h3>Conclusion</h3> It appears that virtual programming can actively engage youth and their families in farm to school education and may be a tool to supplement resource intensive hands-on strategies in the future. Further research is need to determine which components are best suited for web-based delivery vs in person delivery.

P46 Farm to School Program Prevalence: Do School Characteristics Matter?

<h3>Background</h3> Farm to School programs (FTSP) have been promoted as part of the Healthy, Hunger-Free Kids Act (HHFKA) to improve school children's access of nutritious, local food. <h3>Objective</h3> We investigate the prevalence of FTSP in K-12 schools before and after the implementation of the HHFKA. We also examine differences in prevalence of FTSP by school-level (elementary vs middle/high school), proportion of students enrolled from various race/ethnicity groups and proportion of students eligible for free or reduced-price meals (FRPM). <h3>Study Design, Setting, Participants</h3> A secondary analysis of data collected between 2010–2017 from 148 schools participating in the New Jersey Child Health Study (NJCHS) was analyzed. Schools were located in 4 low-income high minority cities in NJ: Camden, New Brunswick, Newark, and Trenton. <h3>Measurable Outcome/Analysis</h3> Schools' personnel answered surveys at 3 time points between 2010-2017 and reported on their schools' participation in the FTSP for the year of the survey and the previous year. Bivariate and multivariate analyses were conducted to examine FTSP prevalence rates for each year of data collection and for time periods categorized as before and after the implementation of the HHFKA. Differences in prevalence rates were compared by school characteristics. <h3>Results</h3> Across all years, on average significantly (<i>P</i> < 0.001) more elementary schools (21%) participated in the FTSP compared to middle/high schools (8%). Based on multivariate logistic regression analysis, compared to 2010, the odds of FTSP participation were 4-5 times higher in 2016 (<i>P</i> = 0.008) and 2017 (<i>P</i> = 0.003). Adjusted estimates show that across K-12 schools, participation increased from 7% in 2010 to 26% and 27% in 2016 and 2017, respectively. No differences were observed in FTSP participation by other school demographics. <h3>Conclusion</h3> Elementary schools are more likely to participate in FTSP and rates of participation in the program across K-12 schools have increased significantly in recent years.

Parental Involvement in Behavior Formation of Children: A Study on Primary Schools of Azad Jammu and Kashmir

This study was conducted to explore the parental involvement in behavior formation of children in Azad Jammu and Kashmir.The study was descriptive in nature, and survey method was used to collect the data. The population of the study consisted of 241 teachers working at Government primary schools of Tehsil Nakyal AJ And K. universal sampling technique was applied because the population was quite manageable, so the researcher selected the whole population as a sample of the study. A questionnaire was used to find out the parental involvement in behavior formation of children. The data were collected through a google form. The collected data were analyzed by using Statistical Package for the Social Sciences (SPSS). The researcher applied frequency, percentage, and mean for the analysis of data. It was found that parents develop cultural values in their children by showing positive emotions, parents have proper control of children's unauthorized access to media content, and also educate their children about the negative effects of mass media.

The problematization of child sexual abuse in policy and law: The Indonesian example

BackgroundIndonesia has a strong national child protection policy. Yet significant limitations exist in laws, policy implementation, and coordination of services, especially regarding child sexual abuse. This is related to a lack of knowledge about child sexual abuse in Indonesia and associated taboos that constrain policy development. ObjectiveTo understand how child sexual abuse problems have been represented in national child protection policy. Method‘What's the problem represented to be’ (Bacchi, 2009) is an analytic approach that uses discourse analysis. This method was employed to examine how child sexual abuse problems in Indonesia are constructed and represented in six government documents (two laws and four national policies). ResultsThree overarching problem representations of child sexual abuse were identified: (1) children are a vulnerable, at risk, and disempowered group; (2) service access is limited and services are not coordinated; and (3) there is a lack of agreement and clarity across laws and policy in child protection. For example, inconsistencies of policy and laws regarding the minimum age for marriage can result in gender discrimination and limit a child's access to justice, protection, and services. ConclusionPolicy discourses play a crucial role in the construction and representation of child sexual abuse problems in Indonesia. Current inconsistencies constrain the implementation of effective intervention and prevention programs. Further work on policy harmony is needed as well as improving community understanding of child sexual abuse.

Memitigasi Peran Orang Tua Di Keluarga Kristen Dalam Menanggulangi Dampak Disinformasi Dari Bingkai Teologi Pentakosta

The period in which believers live today is a time marked by the ease with which information is obtained. Unfortunately not all information is good, correct, and useful because there is a lot of information circulating out there that is deliberately created to spread hatred, lies, moral depravity, and various other acts that are contrary to Christian faith. The purpose of this article's research is to illustrate the important role that parents in Christian families can play in overcoming the disinformation impact of the Pentecostal theological framework. In this study, researchers used a descriptive analysis method and literature review. The results of this study offer four practical steps that parents in Christian families can take in stemming disinformation in their families, namely by taking protective measures in the form of regulating and restricting children's access to the internet, providing assistance, opening discussion spaces, and being examples that can be followed. by the child.

The relationship of interactive technology use for entertainment and school performance and engagement: Evidence from a longitudinal study in a nationally representative sample of middle school students in China

Interactive technology use (e.g., Internet and video games) can promote children's educational access and achievement. However, excessive technology use, particularly for entertainment, may adversely affect children's educational development. This study examined the relationship of the amount of entertainment-related interactive technology use and school engagement and performance using two-wave survey data collected from a nationally-representative sample of middle school students in China (N = 9,949, 48% girls, Mean age = 13.5 years). Results showed that nearly 40% of children used interactive technology for entertainment/non-schoolwork-related activities on school days, and, 62%, for entertainment/non-schoolwork-related activities on weekends. Multilevel mixed models revealed that excessive use of technology for entertainment/non-schoolwork-related activities (i.e., 1+ hours on a school day and 4+ hours daily on weekends) was significantly, adversely associated with all outcomes one year later, including lower test scores on Chinese, Math, English, and cognitive competencies, lower educational aspirations, and higher likelihoods of truancy, lacking concentration in class, and boredom at school. Potential reasons for the findings as well as their implications for research and intervention are discussed. Findings will inform the development of feasible and effective guidelines to help parents, teachers, and schools regulate interactive technology use among school-aged children.