Disorders In School Children Research Articles

Information-based multivariate decoding reveals imprecise neural encoding in children with attention deficit hyperactivity disorder during visual selective attention.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children. Attentional orientation is a potential clinical diagnostic marker to aid in the early diagnosis of ADHD. However, the underlying pathophysiological substrates of impaired attentional orienting in childhood ADHD remain unclear. Electroencephalography (EEG) was measured in 135 school-age children (70 with childhood ADHD and 65 matched typically developing children) to directly investigate target localization during spatial selective attention through univariate ERP analysis and information-based multivariate pattern machine learning analysis. Compared with children with typical development, a smaller N2pc was found in the ADHD group through univariate ERP analysis. Children with ADHD showed a lower parieto-occipital multivariate decoding accuracy approximately 240-340 ms after visual search onset, which predicts a slower reaction time and larger standard deviation of reaction time. Furthermore, a significant correlation was found between N2pc and decoding accuracy in typically developing children but not in children with ADHD. These observations reveal that impaired attentional orienting in ADHD may be due to inefficient neural encoding responses. By using a personalized information-based multivariate machine learning approach, we have advanced the understanding of cognitive deficits in neurodevelopmental disorders. Our study provides potential research directions for the early diagnosis and optimization of personalized intervention in children with ADHD.

ADHD diagnosis and methylphenidate consumption in children and adolescents: A systematic analysis of health databases in France over the period 2010-2019.

ContextADHD is the most common mental disorder in school-aged children. In France, methylphenidate is the only drug authorized for ADHD. Here, we describe the pattern of ADHD diagnosis and methylphenidate prescription to children and adolescents from 2010 to 2019.MethodsWe conducted a retrospective cohort study of all beneficiaries of the French general health insurance scheme (87% of the population, 58 million people). We extracted information for all children and adolescents aged 0–17 years who received: (1) A diagnosis of ADHD (34,153 patients). (2) At least one methylphenidate prescription (144,509 patients). We analyzed the clinical, demographic, institutional, and social parameters associated with ADHD diagnosis and methylphenidate consumption in France.ResultsThe ADHD diagnosis among children and adolescents increased by 96% between 2010 and 2019. ADHD diagnosis affects more boys than girls. About 50.6% of children hospitalized with a diagnosis of ADHD in 2017 also had another psychiatric diagnosis. The rate of children hospitalized with an ADHD diagnosis and treated with MPH varied between 56.4 and 60.1%. The median duration of MPH treatment for a 6-year-old ADHD child initiated in 2011 is 7.1 years. In 2018, 62% of ADHD children were receiving at least one psychotropic medication. Between 2010 and 2019, methylphenidate prescription increased by +56% for incidence and +116% for prevalence. The prevalence of methylphenidate prescription reached between 0.61 and 0.75% in 2019. Boys are predominantly medicated. The median duration of treatment among 6-year-olds in 2011 was 5.5 years. The youngest children received the longest treatment duration. Diagnoses associated with methylphenidate prescription did not always correspond to the marketing authorization. Among children receiving the first prescription of methylphenidate, 22.8% also received one or more other psychotropic drugs during the same year. A quarter of initiations and half of renewals were made outside governmental recommendations. Educational and psychotherapeutic follow-up decreased from 4.1% in 2010 to 0.8% in 2019. French children and adolescents, who were the youngest in their class were more likely to be diagnosed (55%) and prescribed methylphenidate (54%). Children from disadvantaged families had an increased risk of ADHD diagnosis (41.4% in 2019) and methylphenidate medication (25.7% in 2019).

Ocular biometric parameters of mild hyperopia to mild myopia children aged 6-14 years from Wenzhou optometry center: A cross-sectional study.

IntroductionMyopia is the most common visual disorder in school-aged children and adolescents worldwide. This study aimed to explore the ocular biometric characteristics of children aged 6–14 years from the Wenzhou optometry center and to determine the relationship between spherical equivalent refraction (SER) and macular pigment optical density (MPOD).Subjects and methodsParticipants underwent a full-scale ophthalmic examination anteriorly and posteriorly. Relevant parameters were documented, such as axial length (AL), anterior chamber depth (ACD), SER and lens thickness (LT), corneal curvature radius (CCR), and MPOD. Lens power (LP) was calculated using Bennett’s formula. Shapiro–Wilk tests and histograms were used to check the normality of the distribution of refractive and ocular biometric parameters. Scatter diagrams were adopted to analyze the relationships between refraction and parameters of ocular biometry. Multiple linear regression models were employed to fit the associated factors of AL, AL/CCR, and LP.ResultsA total of 902 mild hyperopia to mild myopia (+3.00 D ≤ SE ≤ −3.00 D) children aged 6–14 years were included. The mean age of participants was 10.03 ± 2.47 years, and the prevalence of mild hyperopia, emmetropia, and myopia was 5.65, 27.05, and 67.30%, respectively. The prevalence of mild myopia increased from 30.53% at 6 years of age to 93.62% at 14 years of age. Overall, AL, ACD, and AL/CCR increased, but LP declined from 6 to 14 years of age, whereas CCR and MPOD remained stable. An increase of 1 mm in AL was associated with −0.69 D of myopic change. A unit increase in AL/CCR was associated with −7.87 D in SER. As for the SER variance, AL explained 30.5% and AL/CCR explained 51.1%, whereas AL/CCR and LP accounted for 59.2%.DiscussionIn this work, we have studied the distributions of ocular biometric characteristics of mild hyperopia to mild myopia children from the perspective of an optometry center rather than a sampling survey. In addition, we found that children from the optometry center had a slower progression toward myopia than those from previous sampling surveys, which was an informative finding for future myopia prevention. In addition, we have made a correlation analysis between the macular pigment optical density and spherical equivalent refraction. Though, no correlation was found.

Comparative characteristics of the prevalence of health disorders in schoolchildren with standard weight and overweight, including obesity

It has been proven that against the background of overweight and obesity, the risk of systemic chronic diseases increases. The article presents the results of studying the characteristics of the indicators of the prevalence of health disorders in schoolchildren with normal and overweight and obesity in a comparative aspect. A survey was conducted of 2159 schoolchildren aged 7–17 years, including 1096 boys/boys and 1063 girls/girls from 6 schools in the Novosibirsk region. Data on chronic morbidity and pathological afflictions of children were copied according to the data of form N 026/y-2000, for respondents in grades 10–11 with overweight (n = 100 people), data on the length and weight of the body were copied in a longitudinal aspect with the purpose of identifying the age of formation of overweight and obesity in order to build a prospective forecast of the prevalence of overweight and obesity in schoolchildren in grades 1–4 upon reaching the age of 16. Parametric statistical methods were used with the calculation of the mean (M) and standard error of the mean (±Se), as well as the methods of correlation and regression analyses. Differences were considered statistically significant at p < 0.05. The revealed differences in the prevalence of chronic diseases in children with overweight and obesity and in children with normal body weight indicate the significant importance of overweight and obesity in the formation of diseases of the circulatory system, endocrine system, food allergies and flat feet. There were no statistically significant differences in the prevalence of chronic diseases of the digestive system, nervous system, visual impairment (p ≥ 0.05). The data obtained with the predicted prospect of an increase in overweight in primary school students indicate the need for continuous development and implementation of both collective and individual prevention measures aimed at minimizing the risks of developing concomitant diseases.

Empowering teachers to screen, guide, and refer schoolchildren with behavioral and mental health problems. A pilot study to promote mental health in Iran.

BackgroundSchools are ideal for promoting the mental health of school-age children, but the teachers' current knowledge is insufficient to play an influential role in mental health services at schools. Fortunately, however, teachers have a high sense of responsibility, interest, and talent to receive knowledge and the ability to participate in this field. This study aimed to examine whether a protocol focused on the role of teachers could identify, guide, and care for school-age children with behavioral and mental health problems.MethodThe current research was a “before and after” pilot quasi-experimental study conducted in three elementary, secondary, and high schools. The main intervention consisted of a 5-h workshop based on a ready-to-use booklet for teachers conducted separately in each school. A total of 58 teachers and 872 school-age children were included using a judgmental sampling technique.ResultsThe pre-and post-workshop mean scores of teachers' knowledge about common mental disorders in school-age children were 6.21 ± 4.58 and 12.50 ± 7.27, respectively. According to the Strengths and Difficulties Questionnaire (SDQ), the teachers made 127 referrals, of whom 102 school-age children had problems. Consultants diagnosed 114 school children who reflected 90% of all teachers' recommendations needing psychological care and counseling. Finally, only 50 diagnosed school-age children were followed up and attended therapy sessions at counseling centers. The sensitivity and specificity of this brief intervention in detecting school-age children with psychological problems were respectively 80.3 and 98.0%.ConclusionsThis study's results support teacher empowerment training's effectiveness in identifying and guiding school-age children needing mental health care. Psychological counseling programs in schools in various quantitative and qualitative dimensions, including responding to school-age children's needs and psychological problems, should be adequately evaluated, and appropriate measures should be taken to promote mental health services. Collaboration between health systems and the education department will increase the effectiveness of mental health programs' promotion and drug abuse prevention. These pilot data lead the way to designing scientifically sound follow-up studies that will concretely ascertain the benefit of this program.

Associations between Dietary Intake and Attention Deficit Hyperactivity Disorder (ADHD) Scores by Repeated Measurements in School-Age Children.

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in school-age children and adolescents. However, the reported associations between ADHD and single nutrient intake are inconsistent. The aim of the study was to investigate the relationships between dietary intake changes and the prevalence of ADHD over time with repeat measurements using data from the Children Health and Environment Research (CHEER). To assess changes over time, we used data obtained in 2006 and 2008 (Phases 1 and 2). In this study, there were 2899 children aged 8 years or older in Phase 1 and 2120 children aged 9 years or older in Phase 2 from Korea, and the ADHD scores and dietary intake of 1733 children in Phases 1 and 2 were used in the final analysis. The YN group refers to children whose disease had improved in Phase 2, and the NY group refers to children diagnosed with ADHD in Phase 2. A notable within-group result was the increase in vegetable protein (p = 0.03) in the YN group. A between-group comparison showed that significant changes in nutrient intake could be confirmed most in the NY group, and the YN group tended to have a lower nutrient intake than the NY group. In the correlation of changes in nutrient intake and three subtypes (combined, AD, and HD), the total fat (p = 0.048) and animal protein (p = 0.099) showed a positive correlation with the prevalence of AD. Vegetable iron (p = 0.061 and p = 0.044, respectively), zinc (p = 0.022 and p = 0.007, respectively), vegetable protein (p = 0.074), and calcium (p = 0.057) had inhibitory effects on ADHD and its subtype. In conclusion, management of dietary and nutritional status should be considered to ameliorate ADHD and its subtypes in school-age children, and these relationships require further exploration in other settings.

Development of postural disorders in schoolchildren

Introduction. Pathologies of the musculoskeletal system have been occupying the leading place in morbidity among schoolchildren for a long time. Our research aim was to examine peculiarities of developing postural disorders in schoolchildren from different age groups. Materials and methods. We examined seventy two primary schoolchildren (their average age was 8.19±0.32 years); 87 middle schoolchildren (12.94±0.24 years); and 54 senior schoolchildren (16.65±0.21 years). These test groups were comparable for gender and social background. The health of the musculoskeletal system was assessed on the base on data of a medical examination and results by laboratory tests (phosphor-calcium metabolism); postural disorders were examined as per surfaces with a computer optical topographer; bone mineral density was determined by ultrasound osteodensitometry; body composition was assessed with bioimpedance analysis (BIA). Results. Pathologies of the musculoskeletal system were detected in 77-83.3% schoolchildren. Each second child in primary and middle school had deforming dorsopathy and each second senior school student had scoliosis. We established a probability of developing scoliosis to be by 5.9 times higher in senior school. Children in primary school predominantly had twisting postural disorders (28.4%) and swayback (11.1%) accompanied with the lower phase angle, a lower share of active muscle mass detected with BIA and osteopenia developing in ¼ cases. 16.1-26.1% of middle schoolchildren had twisting postural disorders and kyphosis, 57.9% children in this age group had lower contents of ionized calcium in blood, 28% had osteopenia and a decrease in fat-free mass detected with BIA. Scoliosis in senior schoolchildren (51.9%) and kyphotic-lordotic back (24.1%) were accompanied with lower contents of phosphor and alkaline phosphatase, developing apparent osteopenia (18.4%) and lower mineral mass. We established the probability of postural disorders developing in three surfaces to be 3.3 times higher among teenagers in senior school. Limitations. The results of the studies can only be extrapolated to the population of 7-17 years children of both genders. Conclusion. We revealed certain peculiarities of developing postural disorders in schoolchildren. They can be used in implementing health-preserving technologies in schools as well as in developing new hygienic and organizational approaches to the conditions of the educational process in schools.

Assessment of risk factors for overweight and obesity in schoolchildren for the development of effective prevention programs

Introduction. This article presents the results of a large-scale research on monitoring the nutrition of students in educational institutions. Nutrition is one of the leading factors determining the health and harmony in the processes of growth and development of the child population. One of the most common consequences of unhealthy eating behavior is overweight and obesity. The study and early detection of risk factors is necessary for the prevention of overweight and obesity, which are an acute problem of modern science and education. The purpose of the study is to assess risk factors for overweight and obesity in schoolchildren in order to develop effective programs for the prevention of childhood obesity and nutritional diseases. Materials and Methods. The research data were collected and processed via the following methods: a questionnaire, analytical and statistical methods using parametric and non-parametric methods of statistics and t-test (in the case of normal distribution of data) and Fisher (U). Differences were considered statistically significant at p<0.05. The STATISTICA-10.0 package and Microsoft Excel were used. Results. As part of the global monitoring of schoolchildren’s nutrition (the survey covered 43.9 thousand schoolchildren from 49 regions of the Russian Federation), the following key risk factors for nutrition-related health disorders in schoolchildren were identified: a violation of the structure of nutrition, unhealthy eating behavior and eating habits, violations in the organization of nutrition in educational institutions and at home. Statistically significant correlation coefficients were found between indicators of normal body weight and family income, between overweight and unhealthy eating habits, and eating behavior, the prevalence of diseases of the digestive system. Forecast indicators of a decrease in the prevalence of obesity with a decrease in the proportion of children with unhealthy eating habits have been established. Conclusions. The results of the study characterize the key risk factors for the development of overweight and obesity in children associated with nutrition. In the future, the results obtained can be used to predict the effectiveness of implemented preventive measures at the level of individual educational institutions and territories of the Russian Federation.

Association of Backpack Loads and Wearing Time with Musculoskeletal Disorders in School Children of Wah Cant Pakistan: Correlational study

Background: Young children are carrying heavy bags to and from their schools. The use of backpacks increases recently because of several factors, including decreased availability of school lockers, increased homework, text books & other belongings being carried to school. All these factors amplify backpack weight which have drastic effects on young students’ musculoskeletal system. Methods: This was a correlational study. Data collection was done between Septembers to December 2018. The inclusion criteria were healthy young boys and girls of school children, with no known history of any musculoskeletal disorder or any other deformity or pathology. Survey was done through self-structured questionnaire and Nordic Musculoskeletal questionnaire. SPSS 21.0 was used for data analysis. Results: A total of 1104 students were included in the study, mean age of the students was 11.90 ± 2.2 (range 8-15) years. There were 48.4% males while 51.6% were females. Frequency of fatigue due to heavy backpack was 61.6%.Neck pain was common in 40.2% students, shoulder pain in 47.4% and the frequency of low back pain was 46.6% .According to BMI 33.2% students had normal BMI and 32.6% students were very severely underweight which is an alarming situation. The correlation of bag pack weight with students BMI was weak positive(r=0.25, p<0.05). Conclusion: This study concluded that the frequency of musculoskeletal pain was high due to carrying heavy backpacks. Upper and low back pain were the most common type. Maximum students carry >16% ratio of backpacks load. Wearing time of backpack was more than 10 minutes.

Primary Care Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder in School-Age Children: Trends and Disparities During the COVID-19 Pandemic.

The aim of this study was to assess rates of primary care provider (PCP) diagnosis and treatment of school-age children with attention-deficit/hyperactivity disorder (ADHD) during the COVID-19 pandemic compared with prepandemic years and to investigate disparities in care. We retrospectively analyzed electronic health records from all primary care visits (in-person and telehealth) of children aged 6 to 17 years seen between January 2016 and March 2021 in a community-based primary health care network (n = 77,298 patients). Study outcomes are as follows: (1) number of primary care visits, (2) number of visits with ADHD diagnosis (ADHD-related visits), (3) number of PCP prescriptions for ADHD medications, (4) number of patients with first ADHD diagnoses, and (5) number of first PCP prescriptions of ADHD medications. Interrupted time series analysis evaluated changes in rates of study outcomes during 4 quarters of the pandemic year (March 15, 2020-March 15, 2021) compared with prepandemic years (January 1, 2016-March 14, 2020). Patient demographic characteristics during prepandemic and pandemic years were compared. ADHD-related visits dropped in the first quarter of the pandemic year by 33% (95% confidence interval, 22.2%-43.6%), returning to prepandemic rates in subsequent quarters. ADHD medication prescription rates remained stable throughout the pandemic year. Conversely, rates of first ADHD diagnoses and first medication prescriptions remained significantly lower than prepandemic rates. The proportion of ADHD-related visits for patients living in low-income neighborhoods was lower in the pandemic year compared with prepandemic years. Ongoing treatment for school-age children with ADHD was maintained during the pandemic, especially in high-income families. Socioeconomic differences in ADHD-related care emphasize the need to improve access to care for all children with ADHD in the ongoing pandemic and beyond.

The factor structure of attention-deficit/hyperactivity disorder in schoolchildren

BackgroundMost studies support a bifactor model of childhood ADHD with two specific factors. However, several studies have not compared this model with a bifactor model with three specific factors, few have tested the actual strength of the factors, and none have examined whether “talks excessively” should be treated as a hyperactivity versus impulsivity symptom in children with ADHD. AimsTo examine the factor structure of ADHD symptoms and evaluate the relative strength of potential factors. MethodsParent-reports on the ADHD-Rating Scale (ADHD-RS-IV) were collected for 2044 schoolchildren from the general population and 147 children with ADHD from a clinical sample. Single-, two- and three-(correlated and bi-)factor models were tested using confirmatory factor analysis. ResultsMost models had a satisfactory fit. However, a correlated three-factor model where “talks excessively” was included as an indicator of impulsivity, and especially a bifactor model with one strong, well-defined general and two/three (ICD-10 defined) weak specific factors fit the data slightly better than the remaining models. ConclusionsThe factor structure is best characterized by a bifactor model with a strong general factor and two/three weaker specific factors. Therefore, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.

Anxiety Disorders Among Students of Adolescent Age Group in Selected Schools of Tiruchirappalli, South India: An Analytical Cross-Sectional Study

Background: Anxiety is one of the most common mental disorders among school-going children and adolescents worldwide. Multiple factors like internalization of the symptoms, lack of proper objective assessment, societal stigmatization, and influence of parental pressure may alter the prevalence and incidence. Aim: The current study is done to identify the prevalence of anxiety disorders in school children and their associated risk factors. Method: A total of 550 students (266 boys and 284 girls), studying in grades 8 to 12 in urban and rural schools chosen by stratified random sampling, were subjected to a questionnaire survey by the team of trained investigators using “Screen for Child Anxiety and Emotion-related Disorder (SCARED)—child Version.” Results: Total prevalence of anxiety assessed using the SCARED scale was 51%. The prevalence of subtypes of anxiety disorders was also identified viz, generalized anxiety disorder—16%, panic disorder—23%, school phobia—17%, separation anxiety—31%, and social phobia—13%. All the disorders showed higher incidence in girls ( P < .01). Discussion: The anxiety disorders were associated significantly with students from rural schools, those studying in the Tamil medium, those staying in hostels, students who had mothers who were employed, and living in extended family environments. Students who walked to school and who had neither of their parents as caregivers were more likely to have panic disorder, school phobia, social phobia, and separation anxiety disorder. Conclusion: This study documented a higher prevalence of anxiety disorders and subtypes and highlighted the factors associated with anxiety disorders in school students of the adolescent age group.

Sleep Complaints Among School Children.

Sleep complaints are common among children. These include both night-time and daytime symptoms, such as trouble falling asleep, problems in maintaining sleep, snoring, and unusual events during sleep and daytime functioning impairment. However, sleep complaints in children are often overlooked and undertreated in clinical practice. Untreated sleep problems may further impact on children's development and will persist into adulthood in some cases. This review summarizes the common sleep complaints and disorders in school children, and provides an overview of the epidemiology, clinical features, consequences, and treatment of the sleep problems.

Gender-Related Clinical Characteristics in Children and Adolescents with ADHD.

Attention Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed neurodevelopmental disorder in school-age children, and it is usually associated with a significant impairment in global functioning. Traditionally, boys with ADHD are more likely to be referred for clinical assessments due to a higher prevalence of externalizing symptoms. However, as regards gender-related differential clinical characteristics between boys and girls with ADHD, further investigation is warranted in light of conflicting results found in currently available literature. In fact, a more precise clinical characterization could help increase appropriate diagnoses and treatment planning. In this context, we carried out a retrospective observational study on 715 children and adolescents diagnosed with ADHD from 2018 to 2020 at our center, in order to describe their gender-related clinical characteristics. Boys displayed higher average IQs, but they were comparable to girls in functional impairments and adaptive skills. Girls displayed higher scores on the Attention Problems subscale of the CBCL 6–18 and on several CPRS-R:L subscales, suggesting higher general ADHD symptom severity. Boys showed higher scores on CBCL 6–18 subscales, such as withdrawn/depressed, internalizing, and obsessive-compulsive problems. In conclusion, girls showed more severe ADHD features and lower IQ in clinically referred settings, while boys showed more internalizing problems and obsessive-compulsive symptoms.

Peningkatan Kualitas Tidur Anak Hospitalisasi Yang Megalami Gangguan Pola Tidur Menggunakan Teknik Sleep Hygiene

Hospitalization is a condition that destroys children living in a hospital, undergoing therapy and treatment for a reason that is planned or an emergency. Hospitalization has been shown to cause restless sleep disorders, the client's inability to get a comfortable position and pain is the most common cause of sleep rest disorder. Sleep Hygiene Therapy is a term used to describe good sleep habits or patterns. Sleep Hygiene as a non-pharmacological therapy for sleep disorders, promotes the formation of sleep routines, good and quality sleep patterns. This study aims to determine and analyze the quality of sleep after applying sleep hygiene to school-age children undergoing hospitalization. The method in this study is applied research involving 2 subjects. The results showed that after being given sleep hygiene therapy in children who experienced sleep patterns during hospitalization in both respondents there was a change in sleep quality from severe sleep pattern disorders to mild. The conclusion of this study is that there is an effect of sleep hygiene intervention on the problem of sleep pattern disorders in school-age children undergoing hospitalization.

Developmental disorders in school children are related to allergic diseases

In children, relationships between developmental disorders such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder and allergic diseases remain controversial, because these diseases show age- and sex-related differences. A proper understanding of the relationships between developmental disorders and allergic diseases should improve medical care for both diseases. We confirmed the prevalence of allergic diseases in elementary school-age children with developmental disorders by grade and sex. The subjects were 446 lower grade and 312 upper grade elementary school-age children who had visited our hospital. The prevalence of allergic diseases among subjects with and without developmental disorders by grade and sex was examined using the diagnostic names on medical records. The prevalence of allergic diseases was significantly higher in lower grade boys and girls with developmental disorders than in those without developmental disorders (boys: OR 3.22, 95%; CI 1.49-6.95; girls: OR: 3.87, 95% CI: 1.27-11.82). The prevalence of allergic diseases was significantly higher in higher grade boys with developmental disorders than in those without developmental disorders (OR: 3.46, 95% CI: 1.59-7.53). Multiple logistic regression analysis in lower grades revealed that ADHD correlated with bronchial asthma (adjusted OR: 3.72, 95% CI: 1.42-9.69) and that autism spectrum disorder correlated with atopic dermatitis (adjusted OR: 4.26, 95% CI: 1.36-13.36). Analyses of children in the upper grades showed that ADHD correlated with atopic dermatitis (adjusted OR: 5.06, 95% CI: 1.28-20.05). Elementary school-age children with developmental disorders were more likely to have allergic diseases. The types of allergic diseases related to developmental disorders differed by grade and sex.

Role of teachers in screening of ocular disorders in school children: A multistage school screening program

Purpose: The aim of the study was to find out whether teachers can be introduced as an effective tool in ocular screening of school children and to list out various causes of visual impairment and ocular abnormalities in school children and provide appropriate measures. Method: A multistage school screening program from August to December 2019 in Trivandrum included 33,990 students from 52 schools. Five stages of the study were training of selected teachers, screening by teachers in the school, comprehensive examination by the hospital team in schools, detailed evaluation of referred children in the hospital, and corrective measures by pediatric ophthalmologists in our hospital. A total of 1480 children were selected randomly from the children identified as normal by teachers to detect false negatives. The pattern of ocular disorders children was analyzed. Results: Out of 33,990 students, 6343 students who were detected to have ocular disorders by teachers (18.6%) were examined by our team. 74.2% (4707 students) of them were confirmed to have ocular problems. Thus teachers were able to identify the eye problems correctly (true positives) in 74.2% children, 25.8% being false positives. True positives include refractive errors (73.4%), allergic conjunctivitis (7.9%), strabismus (1.9%), amblyopia (0.098%), pediatric cataract (0.08%), etc. Out of 1480 randomly selected children, 8 (0.54%) children were false negatives (none had refractive errors). Spectacles were given to 2484 children free of cost. Conclusion: Simplicity of multistage screening, ease of its application, time and cost effectiveness, wider coverage, utility as a continuous process in coming years signifies that introducing teachers as primary vision screeners at their schools is an innovative community-based strategy to address the challenges of childhood blindness in resource-constrained settings.

ПРИМЕНЕНИЕ ТЕАТРАЛИЗОВАННОЙ ДЕЯТЕЛЬНОСТИ КАК УСПЕШНОСТЬ ФОРМИРОВАНИЯ РЕЧИ У МЛАДШИХ ШКОЛЬНИКОВ С СОЧЕТАННЫМИ НАРУШЕНИЯМИ РЕЧИ

The article includes an analysis of the concept and meaning of coherent monological speech of younger schoolchildren, the problems of coherent speech disorders in schoolchildren with combined speech disorders, as well as the conditions for the effective inclusion of theatrical activities in the process of correction of coherent speech of elementary school children. The theatrical activities in correctional speech therapy classes has a positive impact on the comprehensive development of the personality of younger schoolchildren with combined speech disorders, namely, contributes to the increase of mental and speech activity, motivation for communication.

Association between body mass index and presence of skin disorders in schoolchildren

Obesity is a chronic, multifactorial and complex metabolic disorder, in which organic damage can be evident in the short or long term, especially dermatological disorders. With the objective of verifying the association between the body mass index and the presence of dermatological conditions, students at a public school in the backcountry of Bahia were studied. This was a cross-sectional study in which 169 schoolchildren were evaluated. The outcome was skin conditions, and the independent variables were BMI, age, and sex. Data were analyzed with the chi-squared test and an α≤0.05. About 41 students (24.3%) were underweight, 92 (54.4%) were eutrophic, and 36 (21.3%) were obese. Among the dermatological conditions, stretch marks stood out with a prevalence of 58%, followed by cellulite with 26%, and acne with 24.3%. The age group (14-20 years) was significantly associated with BMI values (p=0.05). Similarly, acanthosis (p=0.05), striae, hidradenitis, and cellulite also showed a significant relationship with BMI (p=0.01). There was statistical significance (p=0.01) when the presence of up to six dermatoses was compared with the low weight, eutrophic, and obese groups. Certain skin conditions were significantly associated with BMI. It is necessary to carry out educational awareness and prevention actions aimed at these young people that lead to a reduction in obesity cases, considering that in this group the dermatological changes were more evident.

Special Needs Assessment in Bilingual School-Age Children in Germany

Educational and (psycho-)linguistic research on L1 and L2 acquisition in bilingual children sketches them as a group of language learners varying in many aspects. However, most studies to date have based evaluations of language proficiency or new assessment tools on data from heritage children, while studies on the appropriateness of assessment tools for school-age refugee children remain a notable exception. This study focuses on the standardized assessment tool BUEGA for primary school children, which is, among others, a widespread tool for the assessment of pedagogical support or special needs (SN) in Germany. We compare the performance of 12 typically developing monolinguals (MoTD: 7;3–12;1), 14 heritage-bilinguals (BiTD: 7;1–13;4, L1 Turkish and Arabic), 12 refugee- students (BiTD: 8;7–13;1, L1 Arabic), and 7 children with developmental language disorders (DLD: 7;7–13;9) on the subtests of grammar, word-reading, and spelling. Overall results show that refugee-BiTDs perform in the (monolingual) pathology range. No significant differences emerged between students with DLD and typically developing (TD) refugee students. Considering the assessment of school-related language performance, bilingual refugees are at risk of misdiagnosis, along with the well-known effects of educational disadvantage. This particularly applies to children with low socioeconomic status (SES). Looking beyond oral language competencies and using test combinations can help exclude language disorders in school-age children with limited L2 proficiency.