Children's Decisions Research Articles

Impact of the COVID-19 Pandemic on Lung Function and Treatment Decisions in Children with Asthma: A Retrospective Study.

Background/Objectives: Asthma outcomes in children and adolescents largely depend on parental adherence to prescribed treatment plans. This study investigates how the COVID-19 pandemic influenced parental decision-making in managing their children's asthma, regardless of whether the children were infected with SARS-CoV-2. Material and method: In this research, 146 children with asthma were analyzed based on the following data: demographic parameters (gender, age group, and residence), before and after measurements of FeNO and pulmonary function test parameters were performed to assess the evolution of asthma for infected and non-infected children, exacerbations, parents' compliance with the treatment, changes in treatment steps performed by physicians, and the GINA asthma control levels. Results: The effect of parent self-management of doses was evident in the variation of FeNO and pulmonary function test parameters before and after COVID-19 disease, including children with asthma who did not contract the virus, in the decrease in well-controlled asthma cases, as well as in the number of exacerbations per year. A step-down in treatment doses was statistically associated with increased FeNO values (p < 0.0005), and decreased FEV1 values (p = 0.025). Higher values of FeNO were statistically significantly associated with a higher number of exacerbations per year (p < 0.0005). There was a statistically significant moderately strong association between the treatment steps evolution (decided by the attending physician) and parents' self-management of doses in the attempt to assess the control of the disease of children with asthma (p = 0.019). Also, 80.95% of children for whom the parents performed a step-down in dose no longer presented well-controlled asthma, leading to a statistically significant association relative to the level of asthma control and doses adjustments (p < 0.0005). Conclusions: During epidemiological circumstances, a strong collaboration between the parents/caregivers/pediatric patients with asthma and attending physicians is essential to correctly assess the symptoms and to comply the asthma treatment with ICS and a bronchodilator in order to control the disease.

High school and university students' reasoning about decision-making autonomy and parental authority legitimacy in child-mother conflicts.

This study investigated youths' reasoning about personal autonomy and maternal authority in hypothetical emerging adult child-mother conflicts in Türkiye. High school and university students (N = 138, Mage = 19.72 years) from secular and religious schools completed a self-report questionnaire including eight conflict scenarios where the mother opposes her child's decision to marry a non-Muslim or get a tattoo. Maternal opposition in hypothetical scenarios was presented in the forms of maternal advice and maternal use of haram opposition. Haram opposition implies the declaration of maternal accrued rights (a concept deeply rooted in Turkish culture) as haram. The results showed that participants were more likely to subordinate child autonomy to maternal authority when the mother in hypothetical scenarios was depicted as using haram opposition. Authoritative parenting appeared to strengthen this effect. This study has shown that haram opposition is a psychological control mechanism to subordinate child autonomy to maternal authority.

Children's Decisions About How to Negotiate a Virtual Reality Stepping Stones Task

ABSTRACTOn a daily basis, children make decisions about how to negotiate their physical environment. Sometimes they engage in physical tasks that involve risk, requiring them to judge the safety of how to negotiate the environment safely. Individual differences in children's age, sex, physical size, and personality may impact those decisions. We used fully immersive virtual reality to assess 7–10‐year‐olds' (n = 393; mean age = 8.8 years, SD = 0.8; 50% female) behaviour while stepping across rocks to cross a simulated river. Children's self‐reported thrill and intensity seeking (TIS) personality was also collected. Three outcomes were considered: rocks stepped on, time evaluating the crossing, and time crossing. On average, children used 5 of 7 rocks, spent 7.8 s assessing, and 18.7 s crossing, with substantial individual variations. Taller children crossed using fewer rocks, but this association was subsumed in multivariable models by male gender and higher TIS personality (e.g., β = −5.2 and −2.6, respectively, predicting crossing time). Results have implications for child development theory, injury prevention, playground design, and parenting decisions.

Exploring the Factors and Effects of Students’ Loyalty to Mobile Network Providers in Lagos, Nigeria: An Investigative Study

This study explores the relationship between students' mobile network usage for academic purposes and their loyalty to mobile network providers in tertiary institutions in Lagos. Findings reveal that the majority of respondents (62%) are female, aged between 17–22, and actively engage with mobile internet for academic activities. The study highlights students' academic performance correlates with mobile internet access, with 51.4% achieving a Second – Class Upper grade and 15.1% attaining First Class. Parental education plays a crucial role in students' choice of mobile network providers, with higher-educated parents guiding their children's decisions more effectively. The analysis of mobile internet usage shows that 30.2% of students reported high usage for academic purposes, with 23.5% indicating very high usage. Key activities include online lectures (38.4%) and research, emphasizing mobile internet’s role in academic engagement. Regarding loyalty, 42.6% of students’ associate loyalty with retention, while 23.8% believe recommendation plays a role. MTN emerges as the preferred provider (35.1%), while GLO (16.8%) and IpNX Nigeria (2.2%) have lower preference rates, highlighting network coverage and service quality as critical factors. Psychological and environmental variables influence students’ loyalty to mobile networks, with 68% satisfied with network coverage and 65% valuing customer support. Ordinal regression analysis indicates that age, gender, marital status, and mobile network provider impact academic performance and loyalty. These findings underscore the importance of expanding network coverage, improving efficiency, and enhancing customer service to support students' academic success and foster long – term loyalty to mobile network providers in Lagos.

Impact of Parent’s Communication on Adolescent Social Anxiety

Objective: Knowing the impact of parent’s communication and adolescent social anxiety. Method: The Research type is quantitative, using survey techniques with a teenage population. The sample size was 2135 junior high school students spread across 24 Cities and Districts in West Java. Data was collected for 1 month (October 1-31, 2024). Respondents filled out a Google form containing instruments about parental communication patterns (attitudes towards children's opinions, accepting criticism, involving children in decision-making, enforcing rules, etc) and social anxiety (fear of negative evaluation. social avoidance). Data analysis using Chi-Square and Pearson. Results: Most respondents were 14 years old and lived with their parents; their mother's education was junior high school, while their father's was high school. The position of the children was the first and last child. More than 10% of parents have authoritarian communication with adolescents, although most have democratic communication. There is a significant relationship between the age of respondents and the level of anxiety indicated by the results of the Pearson test with a P value of 0.032. In contrast, parental communication and adolescent social anxiety have a statistically significant relationship, indicated by a p-value of 0.01 using the chi-square test. Novelty: Social anxiety is rarely symptomatic, so parents should be able to recognize the condition early and improve communication patterns immediately

Some Asian Value Reflections on Children's Autonomy.

This paper provides an ethical reflection on "children's autonomy" from the perspective of cross-cultural bioethics based on theories related to Asian values. The author supports the premise of "children's" autonomy and explores the differences between Western and non-Western cultures regarding claims of children's autonomy. By comparing the legal regulations on children's medical decisions in the USA, the UK, Japan, and Taiwan, the paper illustrates the national legal differences in children's decision-making, even under the influence of similar Asian cultural values. The author further explains, adopting Tsai's "Confucian two-dimensional personhood theory" and Markus and Kitayama's "Construal of Self" theory, that although Asian countries like Taiwan have historically been influenced by relational personhood dimension and interdependent self-construal orientation, individual autonomy and children's medical decisions are significantly affected or limited by family or parental determinism. However, under the influence of global human rights values and universal bioethical principles, the conceptions, legislations, and practices have evolved towards respecting individual rights and autonomous choices. Hereby, Tsai's two-dimensional personhood theory can balance the tension between individual autonomy and family determinism, as well as between children's autonomy and paternalism. This theoretical framework can provide a rational resolution to the long-standing cross-cultural bioethical controversy regarding individual autonomy and family determinism, and offer insights and solutions for pediatric ethics and children's medical decisions under Asian values.

Impaired Dietary Decision-Making in Children and Adolescents with Congenital Adrenal Hyperplasia

Introduction: Children and adolescents with congenital adrenal hyperplasia (CAH) are at increased risk for obesity and exhibit differences in brain regions associated with food reward and decision-making. We aimed to understand differences in dietary decision-making between youth with CAH compared to controls. Methods: A total of 37 youth with CAH (12.2 ± 3.1 y, 59.5% female) and 100 controls (11.7 ± 2.4 y, 57% female) rated 30 low- and 30 high-calorie foods for health, taste, and liking. Participants then chose between 100 food pair trials using a mouse-tracking paradigm; 75 were discordant for health and taste ratings. Self-control success was measured as the percentage of trials in which the healthier food was chosen instead of the tastier food. Area under the curve (AUC) and maximum deviation (MD) are used as real-time indices of decision-making. Results: Patients with CAH exhibited higher AUCs (CAH: 9.48 ± 8.08, control: 6.40 ± 7.33; p < 0.05) and MDs (CAH: 0.20 ± 0.13, control: 0.15 ± 0.12; p < 0.05) in self-control trials. However, patients with CAH and controls did not differ in their self-control success (CAH: 28.47 ± 24.27%, control: 35.16 ± 25.01%; p = 0.16). In youth with CAH, testosterone was correlated with AUC (R = 0.46, p < 0.01) and MD (R = 0.38, p = 0.02) during successful self-control trials. Conclusions: Children and adolescents with CAH exhibit more cognitive conflict when choosing between healthy and tasty foods. Two indicators of disease severity were associated with cognitive conflict during food choice in patients with CAH. Our findings suggest impaired dietary decision-making in CAH could contribute to obesity risk.

Generous descriptive norms change children's pre-existing decisions and expectations about sharing behaviour.

Previous studies suggest that generous norms influence sharing behaviour from middle childhood onwards. However, no previous study has assessed how these norms could change prior sharing decisions and beliefs about others' sharing behaviour and whether such beliefs may be linked to behavioural change promoted by generous norms. Through a within-subject design, we evaluate 4-to-9-year-old children (N = 111) using two dictator games; one as baseline and the other after being exposed to either a generous or a selfish descriptive norm. Similar to previous studies, the generous norm increased baseline sharing decisions only in children older than 7. In this age group, decisions and beliefs were significantly associated after this norm. Lastly, only the generous norm and not the selfish norm increased expectations about others' sharing behaviour in both age groups. These results suggest that expectations about others' sharing behaviour may support the development of more cooperative sharing behaviour. At least through descriptive norms, it appears more challenging to nudge children to share less and to believe that most children would share selfishly.

How Children's Experiences and Perceptions of Their School Food Environment Influence Their Food-Related Decisions In-School in Urban Ghana.

School food environments play an important role in shaping children's food-related decisions, including where and what foods to acquire and consume on a school day. In Ghana, evidence indicates that food environments in and around schools may limit healthy food acquisition and consumption behaviour. This study aimed to understand how children's experiences and perceptions of their school food environment influence food acquisition and consumption decisions. Data from 18 focus group discussions with children (n = 157; aged 10-17 years) attending Public Basic Schools in the Greater Accra Region of Ghana were analysed, guided by the African urban food environment framework for creating healthy nutrition policies and interventions. Children's food decisions in school were found to be influenced by experiences and perceptions at multiple food environment levels: macro, physical and social levels in combination with individual-level factors. At the macro level, exposure to food advertisements on television emerged as an influence on food-related decisions. At the physical level, experiences and perceptions of environmental sanitation, food vendor hygiene practices, affordability, and food quality were consistently reported to influence decisions. Social-level experiences including influence from friends/peers, family (mostly caregivers/parents) and social qualities of food vendors also shaped food-related decisions. Caregiver/parental dietary advice was often linked to healthier acquisition and consumption decisions by children in school. The findings highlight the need for actions that work in synergy across multiple levels of the school food environment to create conditions that support children to acquire and consume healthier diets.

Perceptual Novelty Drives Early Exploration in a Bottom-Up Manner.

Children are more likely than adults to explore new options, but is this due to a top-down epistemic-uncertainty-driven process or a bottom-up novelty-driven process? Given immature cognitive control, children may choose a new option because they are more susceptible to the automatic attraction of perceptual novelty and have difficulty disengaging from it. This hypothesis is difficult to test because perceptual novelty is intertwined with epistemic uncertainty. To address this problem, we designed a new n-armed bandit task to fully decouple novelty and epistemic uncertainty. By having adults and 4- to 6-year-olds perform the task, we found that perceptual novelty predominated 4-year-olds' (but not adults' or older children's) decisions even when it had no epistemic uncertainty and had the lowest reward value. Additionally, 4-year-olds showed such a novelty preference only when the option's novelty was directly observable, but not when it could only be anticipated, providing new evidence that perceptual novelty alone can drive elevated exploration in early development in a bottom-up manner.

Dilemma: Utilizing the activation decision-construction-action theory to understand and predict children's hypothetical decisions to conceal cases of school bullying.

Dilemma: Utilizing the activation decision-construction-action theory to understand and predict children's hypothetical decisions to conceal cases of school bullying.

The Effectiveness of Financial Literacy Education on Children's Economic Decision-Making: A Meta-Analysis Approach

This study aims to determine the influence of financial literacy education on children's economic decision-making. This type of research is quantitative research with a meta-analysis approach. The inclusion criteria in this study are 1) data from national and international journals indexed by SINTA and Scopus, 2) research published in 2021-2024, 3) research must be relevant, 4) research data must report complete data to calculate the effect size value. Research data was obtained from 25 studies that have met the inclusion criteria—data analysis with the help of the JASP 0.8.5 application. The study's results concluded that the average effect size value was ( d = 0.994; z = 11.198; p 0.001) in the high effect size category. These findings show that financial literacy education significantly influences children's decision-making.

Disparity of Religious Court Judges' Decisions Regarding Distribution of Rights of an Adopted Child in a Mandatory Will

This study aims to determine and describe the chronology of the distribution of obligatory wills for adopted children in decision no. 5203/Pdt.G/2019/PA.Tgrs, Decision no. 1277/Pdt.G/2016/PA.Tng and Decision no. 1926/Pdt.G/2020/PA.JU as well as the judge's considerations in determining the adopted child's share of the three decisions. The type of research used is qualitative, namely collecting data with the aim of interpreting the phenomena that occur using a normative juridical analysis approach, through studying the decisions of the Religious Courts regarding cases of obligatory wills for adopted children with data sources in the form of research libraries, court decisions, statutory regulations, and books and interviews with the judge who decided the case. The results of the research show that there are differences in the share of adopted children from the inheritance of their adoptive parents. The difference occurs because the heirs left behind are different, such as husband and biological father, so that adopted children get 1/6 of the share, while replacement heirs get 2/3 jointly, and 1/10 when the heirs are siblings. These three decisions can be included in the concept of Islamic justice. It means giving something that is rightfully yours in a balanced manner. Balanced means that everything that exists is accepted at the proper level and not at the same level. However, one large part and one small part can be determined by the expected function.

INVESTIGATING THE INFLUENCE OF PARENTS ON UNIVERSITY STUDENTS' CAREER CHOICES IN BANTEAY MEANCHEY, CAMBODIA

This study seeks to investigate the influence of parents on university students’ career choices in the province of Banteay Meanchey, Cambodia. Cambodian parental cultures often provide valuable guidance and support, significantly shaping their children's decisions. Their influence helps students make informed choices that align with their parents' perspectives and interests, influencing both their university majors and future careers. In this particular scenario, parental influence on university students' career choices is generally acknowledged. However, uncertainties may exist regarding the influence and the specific experiences students have had with their parents. In an effort to accomplish the objectives of this research study, the multifaceted direct influences, personal experiences, and financial support contributing to the nature of parental influence on children are investigated. The goal is to uncover new findings in the digital age that may differ from previous studies. The researchers optimistically hope that these new insights and useful resources will be beneficial tools for future studies.

The Influence of Intentionality and Inhibitory Control on Forgiveness of Children with Disabilities

Although a unanimously accepted definition is not found in the literature, most researchers argue that forgiveness involves decreasing negative emotions towards the transgressor, i.e. the person who has broken a norm, decreasing the motivation to hurt them and increasing positive emotions towards them. Our research aimed to investigate the extent to which school children can distinguish between an intentional violation of a classroom norm and an unintentional violation generated by physiological limitations specific to a disability. According to our results, children in the preparatory class understand that certain undesirable behaviors are caused by a disability, in our case, hearing disability, while other behaviors are not. Furthermore, children's decision to play with a transgressor depends on the intentionality of the rule violation, but according to our data, the transgressor's intention to violate a rule did not influence the number of resources that participants provided. We explain these findings through the theoretical framework proposed by McCullough et al. (2013) on the adaptive role of forgiveness and revenge and we analyze the implications that the present research has for the inclusion process of children with special educational needs.

Childhood Vaccination Decisions during the Pandemic: Tradition, Generational Influence, and Spiritual Perspectives

Background: Vaccination is an attempt to form active immunity in an individual. Vaccination is carried out as a preventive measure against infection, both in adults and children. This study aims to determine the effect of parental attitudes, generational influenced, and spiritual contexts on children's vaccination decisions, in this case, the COVID-19 vaccination. Methods: This study used a cross-sectional online survey method, with parents who have children aged 6–11 and willing to take part in this study as respondents. Data collection was carried out from November 2022 to April 2023. There were 66 participants who met the criteria, and then an analysis was carried out using the Structural Equation Model (SEM) method, which was processed using Partial Least squares (PLS). Results: According to research findings, parents' points of view play an important role in deciding whether to vaccinate their child or not. Up to 58% of respondents said they support vaccinating their children, in this case with the COVID-19 vaccination. Conclussion: Parental attitudes of vaccination in children in this research is strongly influenced by parents' views, so the right approach is needed for parents for the successful implementation of vaccination in children. Other influential factors are spiritual context and generational influence from family regarding COVID-19.

‘The voice of the child? The child has no voice’: an Irish study exploring the voice of young children in decisions regarding contact

Since January 2016, Irish family law courts have been obliged to take into consideration the voices of children in proceedings where decisions regarding contact with parents are being made. This article examines the findings of an Irish study that shed light on how young children’s voices are heard in decisions regarding contact with parents who do not, or no longer, live together. The views of key stakeholders who have some involvement with contact arrangements for young children in the 0–6 years age category are highlighted. A thematic analysis of the data was conducted in order to understand various perspectives on how and under what circumstances young children are heard in contact cases. The findings demonstrate that the voices of young children are virtually absent in family law decisions regarding contact. Determining factors relate to the infrastructure of the courts, a significant lack of resources to support the Irish family law system and significant variation in practice approaches between social and legal professionals. As a result of these findings, suggestions are proposed for informing practice and improving service delivery in family law in a way that best meets the needs and rights of young children.

KNOWLEDGE AND ATTITUDE OF URBAN AND RURAL MOTHER IN AL MUKALLA CITY ABOUT VACCINATION, 2023

Vaccination is a critical public health strategy for preventing infectious diseases in children, yet vaccine hesitancy remains a significant challenge, particularly among mothers who influence their children's health decisions. This study aims to evaluate the knowledge and attitudes of mothers in urban and rural areas of Al-Mukalla, Yemen, regarding childhood vaccinations. A total of 581 women with at least one child under five participated, with data collected on their knowledge, sources of information, and attitudes towards vaccination. Results indicated that urban mothers had a higher level of awareness regarding the importance of vaccination compared to their rural counterparts, with 76% of rural mothers lacking knowledge about its significance. Urban mothers primarily relied on media (71%) and doctors (56%) as information sources, while rural mothers depended more on societal channels. Moreover, urban mothers demonstrated a more positive attitude towards vaccination, in contrast to the skepticism observed among rural mothers, influenced by cultural beliefs and misinformation. The findings highlight a critical need for targeted educational interventions to address knowledge gaps and enhance vaccine uptake, particularly in rural communities, ultimately aiming to improve child health outcomes in the region.

An Application of The Theory of Planned Behaviour: Factors Influencing Parental Decision on Children Involvment in Out-Of-School Music Education

In China's music education and training industry, the exploration of parents' and children's educational decisions on the demand side of the market is crucial to the healthy functioning of the music education market. The current study applies TPB theory and modelling to investigate the factors influencing parental decision-making in children's out-of-school music education participation. The study was conducted in Henan Province, China, with a sample of 650 parents from 21 music education institutions in seven cities in Henan Province. The results of data analyses showed that parental ATT, SN, and PBC all had significant positive effects on PI. PBC directly affected PD, while PI was the most significant influence on PD.

Understanding explore-exploit dynamics in child development: current insights and future directions

Examining children's decisions to explore or exploit the environment provides a window into their developing metacognition and reflection capacities. Reinforcement learning, characterized by the balance between exploring new options (exploration) and utilizing known ones (exploitation), is central to this discussion. Children initially exhibit broad and intensive exploration, which gradually shifts toward exploitation as they grow. We review major theories and empirical findings, highlighting two main exploration strategies: random and directed. The former involves stochastic choices without considering information or rewards, while the latter is driven by reducing uncertainty for information gain. Behavioral tasks such as n-armed bandit, horizon, and patch foraging tasks are used to study these strategies. Findings on the n-armed bandit and horizon tasks showed mixed results on whether random exploration decreases over time. Directed exploration consistently decreases with age, but its emergence depends on task difficulty. In patch-foraging tasks, adults tend to overexploit (staying too long in one patch) and children overexplore (leaving too early), whereas adolescents display the most optimal balance. The paper also addresses open questions regarding the mechanisms supporting early exploration and the application of these strategies in real-life contexts like persistence. Future research should further investigate the relation between cognitive control, such as executive function and metacognition, and explore-exploit strategies, and examine their practical implications for adaptive learning and decision-making in children.