Signs In Children Research Articles

Effect of Photobiomodulation on Salivary Cortisol, Masticatory Muscle Strength, and Clinical Signs in Children with Sleep Bruxism: A Randomized Controlled Trial.

Background: The diagnosis of sleep bruxism (SB) in children is difficult due to the lack of a polysomnographic protocol for this population. Moreover, the gold standard treatment [occlusal splint (OS) therapy] has limitations, as adequate use depends on the child's cooperation. The etiology of SB may include stress factors. Salivary cortisol is a biomarker used as a noninvasive method to evaluate the response to stress. Besides physiological aspects, it is also important to investigate morphological aspects, such as masticatory muscle strength. The aim of the present study was to determine the occurrence of bite marks on the buccal mucosa in children as a complementary sign for the diagnosis of SB and investigate and the effectiveness of photobiomodulation as an alternative treatment for this condition. Methods: Seventy-six children 6-12 years of age were divided into four groups: G1-with SB and submitted to laser therapy over acupuncture points (λ = 786.94 nm, 20 sec per point, fluency = 33.5 Jcm2, energy = 1 J, number of points = 12); G2-with SB, use of OS, G3-with SB and submitted to sham laser therapy; and G4-control group without SB. Clinical signs (bite marks on buccal mucosa and headaches), bite force (BF), and salivary cortisol (biomarker of stress) were evaluated before and after treatment. Statistical analysis involved the Kolmogorov-Smirnov, Shapiro-Wilk, and analysis of variance (ANOVA) tests. Results: Bite marks on the buccal mucosa were significantly associated with SB (p < 0.001). A statistically significant difference was found between the frequency of children with headache before and after treatment in G1 (p = 0.0005) and G2 (p = 0.0001), with no significant differences between the two groups (G1 and G2). The children in G1 had lower BF on both sides compared to the other groups. In the intragroup analysis after treatment, all groups exhibited an increase in salivary cortisol levels. Conclusions: Bite marks on the buccal mucosa can be used as a complementary sign for the clinical diagnosis of SB. Children with SB responded well to photobiomodulation therapy, as evidenced by the reduction in BF and reports of headache.

CHECKDYSC©: Mobile Game for Early Detection of Dyscalculia Signs in Children

CheckDysc is a mobile game which was constructed to diagnose children with Dyscalculia. Dyscalculia refers to learning difficulty which related to mathematics. Commonly, children who struggling with mathematics were categorized as low achievers however most of parents and also pre-school teachers are not aware that these low achiever students could be Dyscalculia. Hence, the aim of CheckDysc is to provide early detection of Dyscalculia signs and alert the parents and pre-school teachers. The CheckDysc was constructed based on feedbacks and guidance from the learning disability experts and teachers. CheckDysc was evaluated in terms of its usability and effectiveness to assess the Dyscalculia signs in children. © 2020, World Academy of Research in Science and Engineering. All rights reserved.

Prevalence of Sonographic Signs in Children with Acute Hepatitis in Zahedan City, Southeast of Iran

Background: Acute viral hepatitis is a common infection in developing countries among children. Different diagnostic methods for acute hepatitis has been introduced. Objectives: In this study, we have determined the prevalence of sonographic signs in children with acute hepatitis. Methods: A total of 383 children with acute hepatitis were studied in Zahedan city, southeast of Iran. The sampling method was by the enumeration of the cases. Patients underwent ultrasonography in which their sonographic signs of acute hepatitis were investigated and analyzed. Results: The mean age of children was 6.1 ± 2.8 years, with 211 (55.1%) males and 172 (44.9%) females. The prevalence of gallbladder wall edema was 20.1% (77 children), periportal lymphadenopathy 15.1% (58 children), hepatomegaly 4.9% (19 children), increased liver echogenicity 53.0% (203 children), decreased liver echogenicity 15.4% (59 children), splenomegaly 1.8% (7 children), and periportal hyperechogenicity 32.4% (124 children). Conclusions: The results indicate that the most common sonographic signs of patients with acute hepatitis were increased liver echogenicity and periportal hyperechogenicity.

Development of The AR School App for Children with Hearing Impairment Who Begin Learning Ecuadorian Sign Language using Augmented Reality

Augmented reality AR has been used for many years in different fields of education. It has provided advantages in learning, However, no applications focused on the initial learning of Ecuadorian sign language for children with hearing impairments in their primary school years have been found. In this paper we present the development of a mobile application based on augmented reality, the Unity tool was used as a platform for mobile devices and the Vuforia SDK complement for augmented reality. With this application, the child can see the gesticulation of words in sign language through the use of printed templates. It also has an option to perform a quiz that will allow it to evaluate the knowledge the children acquired from the learning module. The mobile application called ARSchool based on augmented reality which is designed and adapted for people with hearing impairment, mainly for school-age children, as support for the initial learning of sign language in Ecuador. Once the application was developed, it was tested both at school and at home, in which teachers and parents made children with hearing impairments interact.

A Systematic Review of Instruments used to Assess Nonverbal Emotional Signs in Children during an Investigative Interview for Suspected Sexual Abuse

Sexually abused young people often display few or no physical symptoms, and delay of verbal disclosure is common. Based on previous research, we assume that sexually abused children and adolescents may display nonverbal emotional signs, which can be assessed during an investigative interview for suspected child sexual abuse (CSA). We aim to present an overview of reported instruments for the assessment of children's and adolescents' nonverbal emotional signs by medical, psychological and forensic professionals during an investigative interview for suspected CSA. Structured search strategies were developed for MEDLINE (OvidSP), Embase (OvidSP) and PsychINFO (OvidSP). Two reviewers independently performed study selection and data extraction. The search yielded 6711 studies, of which nine were included. All included studies had different study aims and reported a variety of purposes for the assessment of nonverbal emotional signs. Eight different, newly developed instruments were used. Although all studies reported the measurement properties of the instruments, insufficient information was provided for analysis of their reliability and validity. This indicates the need for one reliable, validated instrument for the assessment of nonverbal emotional signs. Standardised, generally approved methods to collect uniform and comparable information during the investigative interview for suspected CSA are essential to enhance the knowledge base in this field.‘An overview of reported instruments for the assessment of children's and adolescents' nonverbal emotional signs… during an investigative interview for suspected CSA’Key Practitioner Messages The evidence base in the field of suspected CSA would be improved if professionals worldwide used standardised and generally approved methods for the collection of uniform, comparable information. Further research is required to explore the additional value of the assessment of nonverbal emotional signs in children and adolescents during the investigative interview for suspected CSA. To warrant the sustainable and harmonised collection of relevant nonverbal emotional signs, a valid and reliable assessment instrument needs to be developed.

Innovation and enculturation in child communication: a cross-sectional study.

How can people achieve successful communication when using novel signs? Previous studies show that iconic signs (i.e. signs that directly resemble their referent) enhance communication success. In this paper, we test if enculturated signs (i.e. signs informed by interlocutors' shared culture) also enhance communication success. Children, who have spent less time in their linguistic community, have less cultural knowledge to inform their sign innovation. A natural prediction is that younger children's signs will be less enculturated, more diverse and less successful compared with older children and adults. We examined sign innovation in children aged between 6 and 12 years (N = 54) and adults (N = 18). Sign enculturation, diversity and iconicity were rated. As predicted, younger children innovated less enculturated and more diverse signs, and communicated less successfully than older children and adults. Sign enculturation and iconicity uniquely contributed to communication success. This is the first study to demonstrate that enculturated signs enhance communication.

Driving Improvements in Child Protection and Safeguarding Practice

Driving Improvements in Child Protection and Safeguarding Practice

Reply to: The Use of the Newest Vital Sign in Children.

Reply to: The Use of the Newest Vital Sign in Children.

The Use of the Newest Vital Sign in Children.

The Use of the Newest Vital Sign in Children.

Subtle Motor Signs in Children With Chronic Traumatic Brain Injury.

The aim of the study was to characterize subtle motor signs in children with moderate-severe traumatic brain injury in the chronic phase of injury. Fourteen children with moderate (n = 6) or severe (n = 8) traumatic brain injury, ages 11-18 yrs, who had sustained their injury at least 1-yr before study participation (range 1-14 yrs since injury), and 14 matched typically developing controls were examined using the Physical and Neurological Examination of Subtle Signs (PANESS). To examine the neural correlates of subtle motor signs, measures of total cerebral volume and motor/premotor volume were derived from magnetic resonance imaging. Children with traumatic brain injury had significantly poorer PANESS performance than controls on the total timed subscore, proximal overflow, and the PANESS total score. Participants with severe traumatic brain injury had greater proximal overflow than those with moderate injury, after controlling for age at injury. Across all participants, greater proximal overflow correlated with reduced total cerebral volume, whereas within the traumatic brain injury group, reduced motor/premotor volume correlated with lower PANESS total score. The study highlights the importance of examining subtle motor signs including overflow during clinical evaluation of chronic pediatric traumatic brain injury and establishes the clinical utility of the PANESS as a measure sensitive to chronic subtle motor signs in this population. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Define subtle motor signs including motor overflow; (2) Identify subtle motor signs such as motor overflow during clinical evaluation of children with brain injury; and (3) Explain the relevance of examining subtle motor signs in chronic pediatric brain injury during clinical evaluations. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

برنامج تعليمى لتنمية المفاهيم البيئية (علامات المرور) بإستخدام أسلوب الکولاج (بالإضافه) فى تصميم وتنفيذ بعض ملابس الطفل

برنامج تعليمى لتنمية المفاهيم البيئية (علامات المرور) بإستخدام أسلوب الکولاج (بالإضافه) فى تصميم وتنفيذ بعض ملابس الطفل

Abnormalities of Vital Signs in Children with Cerebral Palsy: Relationship to Physical Disabilities

The autonomic functions of children with cerebral palsy (CP) have not been sufficiently explored, and corresponding abnormalities are underdiagnosed. In addition, studies evaluating the associations between autonomic dysfunctions and the different aspects of motor performance among these children are scarce. We aimed to investigate vital signs in children with CP and compare them to those of children with typical motor development (TMD) and to determine the associations of autonomic dysfunction with the demographic and clinical data and motor characteristics of these children. A convenience sample of 118 children with CP was evaluated in this cross-sectional study. A group of 69 matched children with TMD served as a control group. We measured the vital signs and key pinch and hand grip strengths of all children in the study. Vital signs were recorded while the children rested in a comfortable sitting position. Children with CP were evaluated for muscle tone and motor abilities. Systolic BP, diastolic BP, heart rate, and respiratory rate were significantly higher in children with CP than in children with TMD (p values of 0.03, 0.006, 0.02, and 0.001, respectively), while blood oxygen saturation and oral body temperature were significantly lower (p values of 0.00 and 0.003, respectively). We detected only weak to moderate correlations between some vital sign abnormalities and children with lower motor performance (diplegic and quadriplegic children, children with level IV or V on the gross motor function classification system (GMFCS), and children with low key pinch and hand grip strength). Children with CP had abnormalities in their vital signs at rest, reflecting a state of dysautonomia. Abnormalities included high systolic BP, diastolic BP, heart rate, and respiratory rate and low blood oxygen saturation and oral body temperature. Children with lower motor performance were at a greater risk of dysautonomia.

A possibility for strengthening family life and health: Family members' lived experience when a sick child receives home care in Sweden.

Families often prefer home care to hospital care, and home-care services for ill children are increasing worldwide with limited knowledge of families' needs during curative and palliative home care. The aim of this study was to elucidate family members' lived experience when a sick child received home care from county-based primary healthcare services. A descriptive qualitative design was chosen and 12 families including sick children receiving home care and their mothers, fathers and siblings in the south of Sweden were interviewed between December 2015 and January 2017. The transcribed interviews were analysed using a hermeneutic phenomenological approach. The family members' lived experience was described in three essential themes: "Strengthening family life" relates to how home care induced freedom and luxury in a strained period of life and supported the families' everyday life. Usual social activities and relations were maintained as time and energy was saved when receiving home care. "Promoting health" relates to how the family members' burden of illness decreased as the child's signs of illness alleviated and the well-being of the whole family increased when the child received care in the home. This provided a peaceful respite for family members' psychosocial recovery. The third theme, "Creating alliances," relates to the importance of creating trustful alliances for communicating participation in care. If trustful alliances were not created, parents felt an overwhelming responsibility and family members became anxious. The findings suggest that care in the family's home is a useful complement to hospital care. Home care should be given with close attention to family members' needs and conditions, as positive effects of home care might be jeopardised when expectations and possibilities are not successfully shared.

An Investigation into Prevalence of Neurological Soft Signs in Children with Attention Deficit-Hyperactivity Disorder and Their Siblings

Attention deficit-hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children, which is associated with a high level of comorbidity among siblings of individuals with ADHD. Given the strongly hereditary nature of ADHD, it may include a group of neurobehavioral defects that can be seen with a higher prevalence in the patients’ siblings due to shared genetic origins. The present study was aimed at examining the prevalence rate and mean scores of neurological soft signs in children with ADHD and their siblings and comparing them with a healthy population. Thirty-two children and adolescents with ADHD and an age range of 7 to 16 years old and 32 siblings of them with the same age range were studied using attention deficit-hyperactivity checklist of DSM-IV-TR and K-SADS Questionnaire, and their neurological soft signs were evaluated using NES questionnaire. Afterwards, the results were compared with those of 32 healthy children and adolescents. The total scores on the test of assessing neurological soft signs were 8.34±4.9, 4.6±3.34, and 3±3.25 in the group with ADHD, the siblings, and the control group, respectively. There was a significant difference between the two groups and the control group (p<0.001). Examining neurological soft signs separately showed that the siblings obtained higher scores than the control group on the tests of fist-edge-palm, right-left separation, and audio-visual separation and coordination. In the present study, prevalence of neurological soft signs was higher among the siblings of the children with ADHD than the control group. These auxiliary signs may help find etiological signs of the disorder and identify individuals at risk.

“Those who care much, understand much.” Maternal perceptions of children's appetite: Perspectives from urban and rural caregivers of diverse parenting experience in Bangladesh

Appetite in children is an important determinant of nutritional intake and growth. The information used by caregivers to understand children's appetite can help inform infant and young child feeding promotion and appetite assessment. We conducted a qualitative study to (a) explore maternal perceptions and responses to children's appetite and (b) to identify how these factors differ by type of caregiver, level of maternal experience, and urban versus rural context. We used purposive sampling to recruit mothers and alternate caregivers into 14 total focus group discussions (six to eight participants in each group; N=95) in both urban and rural settings in Bangladesh. To understand children's appetite, caregivers monitor children's dietary patterns, emotional signs, and physical and verbal cues. Healthy appetite was observed by willingness to eat diverse foods, finish offered portions, and by acceptance of foods without excessive prompting. Child illness was cited for a cause of low appetite, which was manifested through fussiness, and avoiding commonly consumed foods. Mothers described a limited set of feeding practices (offering diverse foods, playing, and cheering children with videos) to encourage consumption when children lacked appetite. Mothers' stress related to work was noted as a barrier to identifying appetite cues. Urban mothers described a lower access to instrumental social support for child feeding but informational support than mothers in the rural setting. Understanding caregivers' perceptions of children's appetite may inform strategies to improve responsive feeding and tool development to assess changes in appetite as early indicators of change in health or nutrition status among high-risk children.

한국 아동 인성 평정 척도-수어판 개발 및 타당화 연구

The purpose of this study was to develop the Korean Personality Rating Scale for Children-Sign Language version (KPRCSL), and to examine reliability and validity of the assessment tool. In order to examine reliability and validity on the KPRCSL, deaf who have 3–17 years child (n=115) performed KPRC-SL and test-retest was carried out for 23 deaf persons. Bilinguals in Korean and Korean sign language (n=18) filled out KPRC-SL and original KPRC to verify similarity between both assessment tools. In order to examine inter-rater agreement, children-report form of KPRC had been carried out on child of deaf participants (n=40) and compared with their parent’s report. The results showed that KPRC-SL had acceptable levels of internal consistency (α=.50-.85) and test-retest reliability (r=.47-.89). According to the correlation between subscale of KPRC-SL, the correlation were higher with the subscale measuring the similar construct rather than others. KPRC-SL and original KPRC had significant correlation between corresponding scales (r=.41-.97). Inter-rater agreement were similar with previous studies (M=.23). These results support that KPRC-SL is reliable and valid assessment and it can be useful for detecting mental health problems of CODA.

The Impact of Neurofeedback on Clinical Signs of Children That Have Attention Deficit Disorder and Hyperactivity

This study was an attempt to examine the impact of Neurofeedback on clinical signs of Children that have attention deficit disorder and hyperactivity. The participants of this study 24 boys (6-11) that afflicted to ADHD. The participants of the study randomly divided into two groups and were selected to participate in the study. The experimental group received the Neurofeedback treatment (8 weeks, three sessions in a week). The control group, on the other hand was placed in a wait list. After treatment, CBCL, IVA, QEEG were administered between two groups. The analysis of data revealed that Nero feedback has a significant impact on ADHD children. Moreover, Neurofeedback treatment leads to improve attention deficit disorder and decrease impulsivity in ADHD children.

Children's choice: Color associations in children's safety sign design

Color has been more identified as a key consideration in ergonomics. Color conveys messages and is an important element in safety signs, as it provides extra information to users. However, very limited recent research has focused on children and their color association in the context of safety signs. This study thus examined how children use colors in drawing different safety signs and how they associate colors with different concepts and objects that appear in safety signs. Drawing was used to extract children's use of color and the associations they made between signs and colors. The child participants were given 12 referents of different safety signs and were asked to design and draw the signs using different colored felt-tip pens. They were also asked to give reasons for their choices of colors. Significant associations were found between red and ‘don't’, orange and ‘hands’, and blue and ‘water’. The child participants were only able to attribute the reasons for the use of yellow, green, blue and black through concrete identification and concrete association, and red through abstract association. The children's use of color quite differs from that shown in the ISO registered signs. There is a need to consider the use of colors carefully when designing signs specifically for children. Sign designers should take children's color associations in consideration and be aware if there are any misunderstandings.

Theory of Mind and Reading Comprehension in Deaf and Hard-of-Hearing Signing Children.

Theory of Mind (ToM) is related to reading comprehension in hearing children. In the present study, we investigated progression in ToM in Swedish deaf and hard-of-hearing (DHH) signing children who were learning to read, as well as the association of ToM with reading comprehension. Thirteen children at Swedish state primary schools for DHH children performed a Swedish Sign Language (SSL) version of the Wellman and Liu (2004) ToM scale, along with tests of reading comprehension, SSL comprehension, and working memory. Results indicated that ToM progression did not differ from that reported in previous studies, although ToM development was delayed despite age-appropriate sign language skills. Correlation analysis revealed that ToM was associated with reading comprehension and working memory, but not sign language comprehension. We propose that some factor not investigated in the present study, possibly represented by inference making constrained by working memory capacity, supports both ToM and reading comprehension and may thus explain the results observed in the present study.

Infant feeding: beyond the nutritional aspects

ObjectiveTo draw attention to the importance of interaction between caregiver and child during feeding and the influence of parenting style on dietary habit formation. Source of dataA search was performed in the PubMed and Scopus databases for articles addressing responsive feeding; the articles considered most relevant by the authors were selected. Synthesis of dataThe way children are fed is decisive for the formation of their eating habits, especially the strategies that parents/caregivers use to stimulate feeding. In this context, responsive feeding has been emphasized, with the key principles: feed the infant directly and assist older children when they already eat on their own; feed them slowly and patiently, and encourage children to eat but do not force them; if the child refuses many types of foods, experiment with different food combinations, tastes, textures, and methods of encouragement; minimize distractions during meals; and make the meals an opportunity for learning and love, talking to the child during feeding and maintaining eye contact. It is the caregiver's responsibility to be sensitive to the child's signs and alleviate tensions during feeding, and make feeding time pleasurable; whereas it is the child's role to clearly express signs of hunger and satiety and be receptive to the caregiver. ConclusionResponsive feeding is very important in dietary habit formation and should be encouraged by health professionals in their advice to families.