Child Occupant Research Articles

Effect Analysis of Different Use Ways of a Q10 Child Seat

In this paper, the injury situation of Q10 child dummy was optimized and analyzed by analyzing the impact of different ways of using a certain child seat ,and analyzing the crash test data of a real car based on LS-DYNA crash simulation analysis software after the vehicle benchmarking, by elaborating on the protection of child occupants in different ways of using this type of child seat, so as to provide a reference for the development of child restraint system of new cars. The results show that: Regardless of whether this type of child seat has an optional seat back, adding seat belt Secure Guard and not using ISOFIX fixing, the dummies' injuries show a decreasing trend. This study provides reference for the selection and use of this type of child seat in dynamic test.

Impact responses and injury analyses of a three-year-old occupant seating in forward and rearward facing CRSs using different computational models

To investigate the reliability and necessity of utilising a human biomechanical model in automotive safety, the frontal collision simulation test was conducted employing the TUST IBMs 3YO model and the Q3 dummy model. The kinematic and biomechanical injury parameters of the occupants were comparatively analysed. The results indicate consistent trends in acceleration changes between the two computational models. Variations in neck structure resulted in a 25% to 28% difference in the peak values of neck injury parameters. Differences in spine structure and materials made the spine angle change trends of the Q3 model more sensitive to the type of child restraint system (CRS). The human biomechanical model allows for the evaluation of occupant injury risk from multiple perspectives. Therefore, employing an advanced computational model of the human body with higher biofidelity provides a more reliable and effective method for investigating injury mechanisms and developing protective countermeasures for child occupants.

Pediatric occupant-to-occupant interaction responses in side impact conditions using Q-dummy and child human body models

Objective Road safety of children has improved considerably over the past decade; however, there is still much scope to better protect these occupants. Ensuring adequate protection of children seated in the rear seats requires a greater understanding of how children are injured in side crashes. The purpose of this study was to enhance the knowledge of children’s potential injuries in side impact collisions by the investigation of two different child sizes seated in different positions in the rear seats. The injury metrics associated with the occupant-to-occupant or occupant-to-child restraint system interaction was also identified. Methods Finite Elements Method simulations were performed using a validated simplified vehicle model with fully deformable side components. Dynamic virtual tests according to the Euro NCAP Child Occupant Protection Protocol were performed considering three different scenarios in terms of occupants´ distribution in the rear seats. Simulations were conducted with dummy and human body models. The injury metrics associated with near-side and far-side positions and the occupant-to-occupant interaction were analyzed. Results The 10-year-old child seated in the far-side position presented higher injury values, especially in the head due to the contact with the adjacent child or child restraint occupying the near-side seating position. Similar responses were observed in human body and dummies models in terms of head and neck injury values. However, human body models showed an increase in the chest measurements. Conclusions This study highlighted that the potential injuries of a child seated on the rear seats in a side impact crash are likely to be increased by the presence of an adjacent seat occupant, especially when larger children were seated in the far-side seating location or a CRS was installed in the near-side seating position. Results offer insight into the occupant-to-occupant interaction and occupants’ size as relevant factors to improve children safety under side impact conditions.

Investigation of tissue injuries for rear-row children occupants during frontal crash

This study was based on the analysis of kinematic and injury differences between current engineering practice and real human injuries. The results showed that ATDs could not accurately evaluate the injury of child occupants, children’s tissues and organs were more vulnerable to injury. The peak intracranial stress of the child occupant was 193 kPa, which was predisposed to moderate concussion. The peak disc stress of the child occupant was 244.8 MPa, which caused severe soft tissue injury to the cervical region. Meanwhile, the lung and heart of the child occupant were severely injured, with the peak stress on the lungs at 1.46 MPa, exceeding the injury threshold by a factor of 91.25. The peak stress in the heart was 561 kPa, 2.2 times above the injury threshold. The safety and protection of child occupants need to be considered from a holistic perspective, and this study could inform future optimisation of injury evaluation criteria for children during vehicle accident.

Effects of Ball-Vests for Children Exhibiting Sensory Seeking Behaviour: A Pragmatic Randomized Controlled Trial

ABSTRACT Children with challenges processing sensory information can have difficulties affecting their ability to participate in school activities, which may affect their potential for learning. The aim of this study was to examine the possible effects of an intervention with three weeks use of ball-vests that provide proprioceptive-tactile stimulation for children exhibiting sensory seeking behaviour. Methods: The study was a pragmatic randomized controlled trial that included 142 children (105 boys and 37 girls, mean age 8.9 years) with dysfunction in sensory processing and sensory seeking behaviour. The children´s ability for attention was measured with the “Test of Everyday Attention-Children” (TEA-Ch), their occupational competence in school activities with the “Child Occupational Self-Assessment” (COSA) and the extent of off-task behaviour with the “Observational off-task Behavior among School-children” (OBS-Children). Data was analysed using linear mixed model regression. Results: Children in the intervention group had a significantly larger increase in self-assessed occupational competence than children in the control group (B = 5.78, p = 0.004). No differences regarding attention or extent of off-task behaviour between intervention and control group were found. Trial registration: ClinicalTrials.gov identifier: NCT04173871..

Child vulnerable road user crash injury severity

Road traffic crashes (RTC) are the main cause of mortality, morbidity, and disability for children globally as well as in the United Arab Emirates (UAE). Although vehicle occupants usually account for the majority of children involved in RTC in developed countries and in the UAE, injuries sustained by child vulnerable road users (VRUs) are usually more severe due to their lack of protection compared to child occupants. Such injuries are known to result in long-term suffering for children including disabilities in some cases, thereby posing a severe public health burden and economic losses to the population. However, despite the severity of injuries to child VRUs involved in RTC, studies in the UAE have mostly focused on vehicle occupants for both children and adults. To the best of our knowledge, this is the first dedicated study on child VRU RTC injuries in the UAE. Additionally, the UAE government is promoting an active transportation policy among children in a bid to curb childhood obesity. Hence, this study examined the factors contributing to RTC injury severity for child VRUs in the UAE. The results of this study will help in enhancing the safety outcomes of child VRU RTC injuries as well as providing policy recommendations for safe active transport among children in the country.

Oblique pole-side crash assessment using the six-year-old HBM PIPER

Side impact crashes are one of the most dangerous impact scenarios that a child can suffer. Studies by the National Highway Traffic Safety Administration (NHTSA) have shown that the head and Thorax regions are affected severely. The objective of this work is to perform a numerical evaluation of the oblique pole-side test considering the FMVSS 214-P standard to estimate the Head, Neck, and Thorax injuries for a six-year-old child positioned in the rear seat without any Child Restraint System, two configurations were performed for the oblique pole-side impact: a nearside and a far-side positioning configuration. A six-year-old Human Body Model (HBM) denominated Scalable PIPER Child Model, and the Ford Explorer 2003 were used to perform the test in the LS DYNA® software to assess the biomechanics involved in the crash scenarios. The approach considered a comparative case study with the baseline of the six-year-old child PIPER model to ensure that the positioning adjustment has not affected the mesh quality and interior components for the PIPER child model. The outcomes obtained in case 1 show that the modified PIPER child model has slight outcomes at the shoulder and pelvis zone due to the differences in the body positioning and not by the mesh or the interior interaction between the components. The outcomes obtained in case 2 reflect that the nearside setup obtained the higher measurements for the child occupant. The Ac3ms for Head at nearside test to overcome the Side Criteria established by the Assessment Protocol Child Occupant Protection by Euro NCAP, the kinematics behavior demonstrates the importance of researching children in side crashes to enhance child security, especially in the oblique pole side impact.

The Effect of Play-Based Occupational Therapy on Playfulness and Social Play of Children with Autism Spectrum Disorder: A Systematic Review

ABSTRACT Since play is the main occupation of children, occupational therapists often use play as an approach to improve playfulness. However, for children with autism spectrum disorder (ASD), there is some uncertainty as to whether playfulness and social play can be improved through play-based interventions. To determine the effect of play-based occupational therapy on playfulness and social play of children with ASD, PubMed, EBSCOhost, OT seeker, Scopus, Sabinet, Cochrane, and ProQuest were searched. Rayyan was used to sort studies and extract data, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The methodological quality of the 12 eligible studies was reviewed using the Joanna Briggs Institute (JBI) checklist tool and data were synthesized using meta-analysis techniques. This review found moderate to strong evidence for 11 of the 12 studies, that play programmes, with a combination of guided and free play, individual, and group therapy sessions, effectively promoted playfulness and social play.

Breaking the misery wheel? Fertility control, social mobility, and biological well-being in rural Spain (1835–1959)

Abstract Fertility control strategies became widespread in rural Spain through the twentieth century: a significant number of parents decided to reduce their marital fertility once the advantages of control strategies became widely known. This paper explores the impact of those practices on children through a comparative study of the heights and occupations of grandparents, parents, and children. We analyze more than 1,200 individuals from three different generations born between 1835 and 1959 in 14 rural Spanish villages, studying whether the advantages associated with fertility control were maintained over time favoring a better family status or whether they were diluted in the next generation. The largest increases in height were among children whose parents controlled their fertility by stopping having children before the mother's 36th birthday. However, it does not seem that this increase in biological well-being was accompanied by major episodes of upward social mobility.

Occupational Therapy Practice Guidelines for Autistic People Across the Lifespan.

Occupational therapy practitioners need evidence to support interventions that promote subjective well-being among autistic people and their families through optimal engagement and participation in occupations. These Practice Guidelines are informed by systematic reviews to expand knowledge of interventions that promote access, inclusion, engagement, and optimal participation in occupations that are meaningful to autistic people. Our intent was to foster occupational therapy practitioners' clinical decision-making and reasoning when working with autistic people and their care partners. These Practice Guidelines were developed on the basis of four systematic reviews, supporting evidence and literature, along with continued revisions and integration through an iterative and collaborative process. A total of 98 articles were included in the systematic reviews, which are the foundation for practice recommendations in these guidelines. Forty-eight of the systematic review articles were used to inform the clinical recommendations included in these Practice Guidelines. Strong to moderate evidence indicates the need for multidisciplinary, goal-oriented interventions to support autistic people in different contexts. Although there is only emerging evidence in the inclusion of autistic people's strengths, interests, and perspectives to guide occupational therapy interventions, such practices can enhance the delivery of neurodiversity-affirming and trauma-informed practices. In addition, evidence is needed to support participation in activities of daily living (ADLs) for autistic youths. We recommend the use of strengths-based language to describe autistic people and the use of environmental adaptations, care partner education, and coaching to enhance occupational therapy service delivery. Plain-Language Summary: The literature is sparse regarding neurodiversity-affirming and trauma-informed practices for autistic youths, as well as for participation in activities of daily living (ADLs). These Practice Guidelines provide new information on positive mental health development; self-determination; ADLs, instrumental ADLs, play, and leisure occupations for children, adolescents, and adults; person-centered planning for adolescents and adults; and rest and sleep. Information on health management is also provided. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel etal., 2021; Kenny etal., 2016). However, we respect the use of person-first language and have made a conscious decision to include research articles that have used this language.

Effect of vehicle speed on injury of child passenger in frontal crashes

Speed is major cause of death to vehicle occupants especially children. Studying effect of speed on child injury severity is crucial to establishing safety regulations. This work investigates the effect of vehicle speed on the severity of injury sustained by three-year-old (3YO) children. Restrained 3YO child dummy Finite Element (FE) model was used to conduct crash simulation at impact speed of 40km/h, 46 km/h and 48 km/h in Ford Taurus FE model using LS DYNA code. Vehicle deceleration was found to increase with increase in speed. Head Injury Criteria (HIC36), HIC15, chest acceleration (CA), chest severity index (CSI), chest deflection (CD) and neck moment (NM) were evaluated and compared with National Highway Traffic Safety Administration (NHTSA) threshold. It was found that the injury parameters sustained by 3YO child increased with increase in speed. HIC36 was found to be above threshold for 48km/h and 46km/h. Speed of 40 km/h had all the injury values below the threshold. Chest deflection was lower than the threshold for all the three speeds. Chest acceleration and neck moment were also presented and their values also increase with speed, though, NHTSA doesn’t capture their threshold. The study disseminates information on the effect of speeding on child injuries in frontal crashes for road safety agents and vehicle designers and users. Limiting vehicle speed is therefore crucial to child occupant protection.

The effectiveness of Q6 and PIPER 6-year-old models on quantification of the change of child sitting posture with AEB and its impact on child’s injures in frontal crash

Objective Automatic Emergency Braking (AEB) has a direct impact on the effectiveness of the restraint systems in providing protection toward child occupants. The objective is to evaluate the effectiveness of Q6 and PIPER 6-year-old models in predicting the kinematic responses of child models, and further to quantify and analyze the child injuries during a frontal crash with and without AEB. Methods The finite element model of a booster seat has been validated through a full vehicle test. Based on the validated finite element model, two sled test finite element models for the rear seat booster seat with Q6 and PIPER 6-year-old models were constructed. AEB condition was imposed on above the two models and the kinematic responses of sitting posture including head, neck and chest have been compared in detail. The peak head displacement and neck curvature of Q6 dummy and PIPER 6-year-old models have been compared with the test data from child volunteers. Based on the child model with better predictive capability for kinematic response under AEB, child injuries were evaluated and analyzed for the 50 km/h frontal crash test with and without AEB. Last, this study discussed the effects of internal neck and chest structure difference between Q6 and PIPER 6-year-old models on child kinematic response and the injury risks. Results Under AEB condition, PIPER 6-year-old model has higher head displacement and lower trunk displacement than Q6 dummy model, and the peak head displacement and neck curvature of PIPER 6-year-old model are similar to the test data of child volunteers. During the 50 km/h frontal crash simulation with pre-crash AEB, the HIC15, Head acceleration 3 ms, Nij decrease 43.7%, 19.6% and 28.8%, respectively and the chest deflection increases 15.5% compared to the simulation without AEB. Conclusions This study shows that PIPER 6-year-old model is more suitable for the quantification of sitting posture change under AEB due to its higher biofidelity. The pre-crash AEB can substantially reduce the head, neck injuries. But it also increases the chest injury due to the chest pre-compression. Future efforts are recommended to lower the child chest injury by integrating AEB with active pre-tensioning seatbelts.

Health-seeking Behavior among Mothers of Under-five Children in Sokoto Metropolis, Sokoto, Nigeria.

In most developing countries, the health of the children is strongly dependent on maternal health-care-seeking behavior. The ability of caregivers to recognize and seek appropriate care for childhood illnesses is instrumental in reducing childhood deaths and preventing significant number of complications. The study aimed to determine the health-care-seeking behavior and associated factors among the mothers of under-five (U5) children in Sokoto Metropolis. This was a descriptive, cross-sectional study carried out among 386 mothers of U5 children in Sokoto metropolis from August 1 to September 30, 2021. The study participants were selected using the multistage sampling technique. A structured questionnaire was used to collect the information. Data were analyzed using the SPSS version 24. The level of significance for Chi-square was set at a P < 0.05. Majority 312 (80.8%) of the respondents U5 children had fallen sick in the last 6 months, most of which 238 (61.7%) were not taken to a health facility. The major reasons why respondents do not take their U5 children to a health facility when sick are because they bought drugs from patent medicine vendor and perceiving the illness of the U5 as not serious to warrant taking the child to a health facility in 93 (24.1%) and 63 (16.3%), respectively. There was association (P ≤ 0.05) between health-care-seeking behavior and respondents' level of education, occupation, monthly income, as well as distance taken to reach a health facility within 30 min' walk. The health-seeking behavior of the mothers for their U5 was poor. Maternal level of education, occupation, income, and lesser number of children in the family were the factors that were significantly associated with seeking health facility care for a sick U5. This study recommends girl child education, women empowerment, and increase access to family planning by the government.

The effects of postural support padding modifications to child restraints for children with disability on crash protection

Objective Many children with physical disabilities need additional postural support when sitting and supplementary padding is used on standards approved child restraints to achieve this when traveling in a motor vehicle. However, the effect of this padding on crash protection for a child is unknown. This study aimed to investigate the effect of additional padding for postural support on crash protection for child occupants in forward facing child restraints. Methods Forty frontal sled tests at 49 km/h were conducted to compare Q1 anthropometric test device (ATD) responses in a forward-facing restraint, with and without additional padding in locations to increase recline of the restraint, and/or support the head, trunk and pelvis. Three padding materials were tested: cloth toweling, soft foam, and expanded polystyrene (EPS). The influence of padding on head excursion, peak 3 ms head acceleration, HIC15, peak 3 ms chest acceleration and chest deflection were analyzed. Results The influence of padding varied depending on the location of use. Padding used under the restraint to increase the recline angle increased head injury metrics. Toweling in multiple locations which included behind the head increased head excursion and chest injury metrics. There was minimal effect on injury risk measures with additional padding to support the sides of the head or the pelvis position. Rigid EPS foam, as recommended in Australian standards and guidelines, had minimal effect on injury metrics when used inside the restraint, as did tightly rolled or folded toweling secured to the restraint at single locations around the body of the child. Conclusions This study does not support the use of postural support padding to increase recline of a forward-facing restraint or padding behind the head. Recommendations in published standards and guidelines to not use foam that is spongy, soft or easily compressed, with preference for secured firm foam or short-term use of tightly rolled or folded toweling under the child restraint cover is supported. This study also highlights the importance of considering the whole context of child occupant protection when using additional padding, particularly the change in the child’s seated position when adding padding in relation to the standard safety features of the restraint.

Validation of the Persian Version of Short Child Occupational Profile in Iranian Population

Validation of the Persian Version of Short Child Occupational Profile in Iranian Population

Reproductive late effects and testosterone replacement therapy in male childhood cancer survivors: A population-based study (the Fex-Can study).

Childhood cancer survivors are at risk of various endocrine late effects affecting their quality of life. The aim of this study was to assess the prevalence and predictors of endocrine and reproductive outcomes in young adult survivors. A secondary aim was to assess possible associations between testosterone replacement therapy (TRT) and other endocrine, cardiovascular and psychosocial late effects. This nationwide study comprised 1212 male childhood cancer survivors aged 19-40 years, identified through the National Quality Registry for Childhood Cancer in Sweden. Median age at diagnosis during 1981-2017 was 7 (range 0-17) and at study 29 (19-40) years. The study combined self-report survey data with cancer treatment data from the national registry. Hormone-induced puberty was self-reported by 3.8% of the survivors and ongoing TRT by 6.0%. In separate logistic regression analyses, these treatments were associated with hematopoietic stem cell transplantation and cranial radiotherapy. Hormone-induced puberty was additionally associated with younger age at diagnosis. Men with TRT had a higher prevalence of other endocrine deficiencies, cholesterol medication, depressive symptoms and fatigue as well as a lower probability of living with a partner, having a biological child or current occupation. In the total male cohort, 28.2% reported having a biological child. Reassuring reproductive outcomes after less intensive therapies and low frequency of TRT were observed in young adult male childhood cancer survivors treated in the most recent treatment era. However, men with TRT suffered from several other endocrine, cardiovascular and psychosocial late effects, indicating a need for long-term monitoring of this high-risk group.

Analysis of the influence of geometric difference among rear child occupants on injury outcomes

This study aims to determine the influence of differences in geometric characteristics on lower extremity injury in frontal impact. Occupants with different lower extremity geometries were placed in the same impact environment, and the positioning angles of the lower extremities were consistent. After model validation, multiple sets of experiments were conducted. Responses to injury and kinematics of different lower extremities were compared, and the influence of lower extremity geometric properties on lower extremity injury was analyzed. Results showed that lower extremities with different geometric features produced different injuries and motion responses during impact. Long lower limbs with large femur-tibia length ratios had a wide range of motion. Additionally, the large femur-tibia length ratios increased the load transmitted by the foot to the femur and tibia, and the lower extremity was subjected to high-impact loading. The narrow femur and tibia were subjected to great compressive force and synthetic bending moments at both ends and had a large tibial index. The effects of differences in geometric properties on lower extremity biomechanical injuries can provide insight into lower extremity injury.

The Influence of a Booster Seat on the Motion of the Reclined Small Female Anthropomorphic Test Device in Low-Acceleration Far-Side Lateral Oblique Impacts.

Belt-positioning booster (BPB) seats may prevent submarining in reclined child occupants in frontal impacts. BPB-seated child volunteers showed reduced lateral displacement in reclined seating in low-acceleration lateral-oblique impacts. As submarining was particularly evident in reclined small adult female occupants, we examined if a booster seat could provide similar effects on the kinematics of the small female occupant to the ones found on the reclined child volunteers in low-acceleration far-side lateral oblique impacts. The THOR-AV-5F was seated on a vehicle seat on a sled simulating a far-side lateral-oblique impact (80 deg from frontal, maximum acceleration ∼2 g, duration ∼170 ms). Lateral and forward head and trunk displacements, trunk rotation, knee-head distance, seatbelt loads, and head acceleration were recorded. Three seatback angles (25 deg, 45 deg, 60 deg) and two booster conditions were examined. Lateral peak head and trunk displacements decreased in more severe reclined seatback angles (25-36 mm decrease compared to nominal). Forward peak head, trunk displacements, and knee-head distance were greater with the seatback reclined and no BPB. Knee-head distance increased in the severe reclined angle also with the booster seat (>40 mm compared to nominal). Seat belt peak loads increased with increased recline angle with the booster, but not without the booster seat. Booster-like solutions may be beneficial for reclined small female adult occupants to reduce head and trunk displacements in far-side lateral-oblique impacts, and knee-head distance and motion variability in severe reclined seatback angles.

Comparing Telerehabilitation and In-Person Interventions in School-Based Occupational Therapy for Specific Learning Disorder A Randomized Controlled Trial.

This study investigated the efficacy of telerehabilitation (TR) in school-based Occupational Therapy (OT) for children with Specific Learning Disorder (SLD), focusing on occupational competence and parental satisfaction, aiming to contribute empirical insights to the discourse on the educational well-being of this population. The study adopted a Randomized Controlled Trial (RCT) design involving 31 children diagnosed with SLD, implementing TR and in-person interventions alongside a control group. Outcome measures included the School Self-Concept Inventory, Child Occupational Self-Assessment (COSA), and Canadian Occupational Performance Measurement (COMP), analyzed using descriptive and inferential statistics (ANOVA, post hoc tests). Both TR and in-person interventions exhibited significant enhancements in academic self-efficacy (F=23.96, p<0.001, Partial ȵ²=0.461), occupational competence (F=70.59, p<0.001, Partial ȵ²=0.716), and parent satisfaction (F=17.03, p<0.001, Partial ȵ²=0.378) compared to the control group. Notably, no significant differences emerged between the TR and in-person groups, emphasizing their comparable effectiveness in improving outcomes. In conclusion, the study demonstrated the efficacy of TR and in-person interventions in school-based OT for children with SLD. The cohesive outcomes in academic self-efficacy, occupational competence, and parental satisfaction highlight TR as a versatile modality. This research, grounded in robust methodology, encourages further exploration of TR's transformative role in enhancing the holistic well-being of children with SLDs.

Performance evaluation of the eight-one six-point occupant restraint system based on experiments

In order to further ensure occupant safety, a new type of motor vehicle occupant restraint system is proposed in the paper. According to its structural characteristics, the shoulder belts are shaped like the Chinese number eight (八), the lap belt is shaped like the Chinese number one (一), and it has six fixed points; hence, it is called the “Eight-one six-point occupant restraint system.” The effectiveness of the “Eight-one six-point occupant restraint system” for adult and child occupant protection was verified under frontal impact conditions (50 km/h) and lateral impact conditions (30 km/h) using the Hybrid III 50th percentile dummy and the Q3 child dummy, respectively. Meanwhile, a comparison was made with the safety performance of the typical occupant system. The conclusion indicates that wearing a typical occupant restraint system carries the risk of occupant detachment from the restraint, neck strangulation, and collision interference between occupants on the far side and on the collision side; it also cannot be applied for child occupant protection. However, the “Eight-one six-point occupant restraint” can effectively restrain adult and child occupants within safety areas with a simple and easy-to-wear structure and technological innovation, which has certain application value.