Low Socioeconomic Status Backgrounds Research Articles

Teaching Bilingually: Unlocking the Academic and Cognitive Potential—Teachers’ Insights

Recent quantitative research on bilingual education suggests beneficial academic outcomes for pupils regardless of socio-economic status (SES). Bilingual education in England, a relatively novel phenomenon, may be better understood from teachers’ perspectives; however, there is a paucity of qualitative research in this area. To fill the gap, the present study explores the unique perspective of a sample of bilingual schoolteachers regarding the children who attend bilingual schools and the effects of bilingual education on children’s academic and non-academic development. Semi-structured interviews were conducted with six bilingual schoolteachers, and thematic analysis was adopted to interpret their experiences in greater depth. A thematic analysis revealed four superordinate themes: Academic and Socio-Cultural Effects, Privilege in Bilingual Education, Bilingual Education Takes Time, and Special Educational Needs. These results highlight academic, socio-cultural, and linguistic benefits with important implications for promoting equity in bilingual education. Further research should focus on schools with a higher proportion of students from lower socio-economic status backgrounds.

Patient Factors Associated with Missed Otolaryngology Appointments at an Urban Safety-Net Hospital.

To determine if patient factors related to ethnicity, socioeconomic status (SES), medical comorbidities, or appointment characteristics increase the risk of missing an initial adult otolaryngology appointment. This study is a retrospective case control study at Boston Medical Center (BMC) in Boston, Massachusetts, that took place in 2019. Patient demographic and medical comorbidity data as well as appointment characteristic data were collected and compared between those that attended their initial otolaryngology appointment versus those who missed their initial appointment. Chi-square and ANOVA tests were used to calculate differences between attendance outcomes. Multivariate analysis was used to compare the odds of missing an appointment based on various patient- and appointment-related factors. Patients who were more likely to miss their appointments were more often female, of lower education, disabled, not employed, Black or Hispanic, and Spanish-speaking. Spring and Fall appointments were more likely to be missed. When a multivariate regression was conducted to control for social determinants of health (SDOH) such as race, insurance status, employment, and education status, the odds of females, Spanish-speaking, students, and disabled patients missing their appointment were no longer statistically significant. A majority of patients at BMC come from lower SES backgrounds and have multiple medical comorbidities. Those who reside closer to BMC, often areas of lower average income, had higher rates of missed appointments. Interventions such as decreasing lag time, providing handicap-accessible free transportation, and increasing accessibility of telemedicine for patients could help improve attendance rates at BMC. IV Laryngoscope, 134:4003-4010, 2024.

Metformin’s role in lowering colorectal cancer risk among individuals with diabetes from the Southern Community Cohort Study

BackgroundMetformin, utilized to manage hyperglycemia, has been linked to a reduced risk of colorectal cancer (CRC) among individuals with diabetes. However, evidence is lacking for non-Hispanic Black individuals and those with lower socioeconomic status (SES), who face elevated risk for both diabetes and CRC. In this study, we investigated the association between metformin use and incident CRC risk within the Southern Community Cohort Study (SCCS), a racially- and SES-diverse prospective cohort. MethodsParticipants reported their diabetes diagnosis and medications, including metformin, upon enrollment (2002–2009) and during follow-up surveys approximately every five years. Incident cases of CRC were identified through state cancer registries and the National Death Index. Proportional hazards models were employed to explore the relationship between metformin use and CRC risk, adjusted for cancer risk factors. ResultsA total of 25,992 participants with diabetes were included in the analysis, among whom 10,095 were taking metformin. Of these participants, 76% identified as non-Hispanic Black, and 60% reported household incomes <$15,000/year. Metformin use was associated with a significantly lower CRC risk (HR [95% CI]: 0.71 [0.55–0.93]), with consistent results for both colon (0.80 [0.59–1.07]) and rectal cancers (0.49 [0.28–0.86]). The protective association appeared to be stronger among non-Hispanic White individuals (0.51 [0.31–0.85]) compared to non-Hispanic Black participants (0.80 [0.59–1.08], p-interaction =.13). Additionally, a protective association was observed among obese individuals (BMI ≥30 kg/m2, 0.59 [0.43–0.82] but not among non-obese participants (0.99 [0.65–1.51], p-interaction =.05) ConclusionOur findings indicate that metformin use is associated with a reduced risk of CRC in individuals with diabetes, including among those from predominantly low SES backgrounds. These results support previous epidemiological findings, and demonstrate that the protective association for metformin in relation to incident CRC likely generalizes to populations with higher underlying risk.

Exploring the Abuses and Solutions of Students' Drug Addiction at the University Level

Drug addiction among university students has emerged as a critical issue, particularly in developing nations like Pakistan. This study explores the prevalence and factors contributing to drug abuse among university students, focusing on social, psychological, and economic influences. Peer pressure, socioeconomic status (SES), and mental health challenges have been identified as major risk factors for substance use in the university setting. Data were collected through interviews and focus groups with students and teachers using mixed methods, which provided a broader understanding of the topic. Findings indicate that students from low SES backgrounds are particularly vulnerable due to financial pressures and limited support. At the same time, peer influence generalizes drug use across social groups; the research emphasizes the need for targeted psychosocial intervention strategies aspects of addiction and emphasizes the importance of supportive resources and mental health resources in reducing drug abuse among students.

Policy tug of war: EBacc, progress 8 and modern foreign languages in England

ABSTRACT Modern Foreign Languages (MFL) as a secondary school subject is affected by two policies, namely the English Baccalaureate (EBacc) and Progress 8, which contribute to the measurement of performance in exams at age 16 (GCSEs). In this paper, I discuss the concept of performance measurement in schools and the purpose it purportedly serves, before outlining these two policies and considering how they contribute to the culture of performance measurement and a non-neutral discourse around ‘standards’. I argue that the two policies act in tension in a game of tug of war with one another in such a way that the net positive effect on the subject of MFL is zero, but that the negative effect on students is substantial. I suggest that the policies act to impose middle-class notions of what it means to be educated on students, with a substantial negative effect on students from low socio-economic status backgrounds both in terms of their interest in the subject and their perceptions of their own value within the education system.

Association of Socioeconomic Status With Worse Overall Survival in Patients With Bone and Joint Cancer.

The effect of socioeconomic status (SES) on the outcomes of patients with metastatic cancer to bone has not been adequately studied. We analyzed the association between the Yost Index, a composite geocoded SES score, and overall survival among patients who underwent nonprimary surgical resection for bone metastases. This population-based study used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results database (2010 to 2018). We categorized bone and joint sites using International Classification of Disease-O-3 recodes. The Yost Index was geocoded using a factor analysis and categorized into quintiles using census tract-level American Community Service 5-year estimates and seven measures: median household income, median house value, median rent, percent below 150% of the poverty line, education index, percent working class, and percent unemployed. Multivariate Cox regression models were used to calculate adjusted hazard ratios of overall survival and 95% confidence intervals. A total of 138,158 patients were included. Patients with the lowest SES had 34% higher risk of mortality compared with those with the highest SES (adjusted hazard ratio of 1.34, 95% confidence interval: 1.32 to 1.37, P < 0.001). Among patients who underwent nonprimary surgery of the distant bone tumor (n = 11,984), the age-adjusted mortality rate was 31.3% higher in the lowest SES patients compared with the highest SES patients (9.9 versus 6.8 per 100,000, P < 0.001). Patients in the lowest SES group showed more racial heterogeneity (63.0% White, 33.5% Black, 3.1% AAPI) compared with the highest SES group (83.9% White, 4.0% Black, 11.8% AAPI, P < 0.001). Higher SES patients are more likely to be married (77.5% versus 59.0%, P < 0.0001) and to live in metropolitan areas (99.6% versus 73.6%, P < 0.0001) compared with lower SES patients. Our results may have implications for developing interventions to improve access and quality of care for patients from lower SES backgrounds, ultimately reducing disparities in orthopaedic surgery.

The Impact of Morphological Intervention on Literacy Knowledge and Reading Motivation: A Cluster-Randomized Comparison Trial in Diverse Socioeconomic Status Kindergartens.

This study investigated the effectiveness of a storytelling-based morphological intervention program on the language and literacy knowledge and reading motivation of kindergarten children from low and mid socioeconomic status (SES) backgrounds. It also explored how these groups compared in change scores against a non-intervened high SES group. Employing a cluster randomization approach, this study included 158 kindergarten children, comprising intervention and comparison groups from low and mid SES backgrounds, as well as a non-intervened high SES group. Assessments were conducted on morphological awareness (MA), print concepts, vocabulary, and reading motivation. Children in the intervention groups showed better performance in MA and print concept scores than those in their respective comparison groups. The mid SES intervention group also displayed significant improvement in vocabulary and motivation scores compared to its counterpart. When examining the effects of SES on change scores, the low SES intervention group achieved superior results in vocabulary and print concept scores compared to both the mid SES intervention and the non-intervened high SES groups. For reading motivation, the mid SES group outperformed the low SES group. The morphological intervention program using storytelling positively impacts both the literacy skills and reading motivation of kindergarten children, especially those from low and mid SES backgrounds. This study emphasizes the significance of designing interventions that cater to the distinct educational needs of children from different SES backgrounds.

The impact of school closures during the COVID-19 pandemic on reading fluency among second grade students: socioeconomic and gender perspectives.

The acquisition of reading skills is a crucial milestone in early education, with formal instruction and practice playing pivotal roles. The outbreak of COVID-19 led to widespread school closures and a shift to remote learning. This study aimed to investigate the effects of school closures on reading acquisition and fluency among a large sample of second-grade children, considering socioeconomic status (SES) and gender differences. In 2019, a cohort of 2228 second-grade students from 34 schools was assessed for word reading fluency and comprehension. In 2020, during the pandemic, 765 students from a subsample of 20 original schools were re-evaluated using the same measures. The study also collected school-related data. The findings from the entire sample indicated no significant differences in fluency and comprehension scores between children in the second grade in 2019 and 2020. However, a significant interaction emerged when analyzing low SES versus high SES children. Children from low SES backgrounds exhibited notably lower reading scores after a year of remote learning due to the COVID-19 outbreak. Moreover, the disparity in reading scores between low SES and high SES children nearly doubled in 2020. Gender differences were also detected. These results underscore the impact of remote learning during the COVID-19 crisis on exacerbating gaps in reading fluency and comprehension between children from high and low SES backgrounds. The implications of these findings highlight the critical role of in-person schooling and targeted support for disadvantaged students, especially during pivotal stages of reading development.

The effect of socio-economic status on children's dental health.

The aim of the present study was to record the oral health status of children from different socioeconomic backgrounds and correlate these findings with parent-associated factors. It comprised a cross-sectional study of healthy children, aged 6-12 years, attending either the Reception and Solidarity Center of the Municipality of Athens or the Postgraduate Paediatric Dentistry Department (NKUA) for dental care. Data regarding the demographics of both parents-guardians, as well as the children, and oral hygiene and dietary habits were collected through a structured questionnaire. This was followed by a thorough clinical examination evaluating oral hygiene status, gingival inflammation and caries experience. Analysis was based on the socioeconomic status (SES) of the parents which was according to the family income. Families with a monthly income of <1400 euros were considered as being of a low SES and families with incomes of >1400 euros as medium. Data were presented in frequency tables and significance of calculated differences was tested using chi-square and Fisher's exact tests. Multivariate regression analysis was used to detect possible risk factors for development of poor dental health. The sample consisted of 216 children (146 from a low and 70 from a medium SES) with a mean chronological age of 9.19 years. Parents from low SES were younger, of lower education, had lived abroad most of their lives and were unemployed or worked in the private sector. Children from low SES backgrounds reported infrequent dental visits, consumed more meals and had more sugary snacks. This was reflected in their worse dental health with significantly higher values for oral hygiene and caries indices. Despite the above differences, none of the parent-associated factors were significantly correlated to worse dental health. In conclusion, SES of parents is reflected in the oral health of children, although it is not a significant predictor of dental health.

Personal agency among students from low socio-economic backgrounds: An examination of student profiles, perceived teaching support, and achievement

Personal academic agency—the thoughts, actions, and emotions that impact individual functioning at school—is central for academic success. On average, students from low socio-economic status (low-SES) backgrounds report lower levels of personal academic agency than their more advantaged peers, but there are also many who achieve academic success. Identifying different personal academic agency profiles among students from low-SES backgrounds may assist in targeting efforts to boost these factors within that population—and to identify students who are faring well, as well as those who might require additional support. This study examined five factors of personal academic agency (perceived competence, school belonging, perseverance, academic buoyancy, and conduct problems) among 20,125 secondary school students from low-SES backgrounds at 421 Australian schools. We identified profiles of students that vary in patterns of personal academic agency, and examined teaching support predictors and achievement differences associated with profile membership. Latent profile analysis revealed five student profiles: Vulnerable (9% of sample), Resigned (27%), Precarious (28%), Average (32%), and Flourishing (14%) profiles. Students’ perceptions of teaching support predicted membership in more adaptive profiles (i.e., Average and Flourishing profiles)—with the most consistent teaching support predictors being emotional support, classroom management, and instructional relevance. In addition, the Flourishing profile displayed the highest achievement.

Socioeconomic Status and its Impact on Receptive Vocabulary and Executive Function in Young Children

This article examines the impact of Socioeconomic Status (SES) on the development of receptive vocabulary and executive function in young children. Integrating current research, the paper highlights the challenges faced by children from low SES backgrounds in terms of language comprehension and executive functioning. Studies indicate a close relationship between SES and a child's receptive language abilities and executive functions, which are crucial for overall learning and development. The article also explores how SES influences cognitive development in children through various pathways, such as home language environment, stress levels, and access to resources. Additionally, the paper discusses early intervention measures and policy recommendations for children from low SES backgrounds to bridge the developmental gap associated with SES.

Equity in Maths: Mechanisms Underlying the Sharpening of the Gender Gap

Given that early maths skills are crucial predictors of later academic success, the results from the latest maths SIMCE (System for Measurement of Quality in Education) are cause for alarm. These results reveal a concerning setback in gender equality in mathematical learning, particularly affecting girls from low socioeconomic status (SES) backgrounds. Neuroscience indicates that both men and women share a similar biological basis for mathematical learning. Hence, the observed gender gap may be attributed to social beliefs associating mathematics more with masculinity than femininity. In Chile, studies have demonstrated that these beliefs are prevalent among teachers, families, and children as young as 5 years old, even more so than in other countries. It is also evident that these beliefs vary based on gender and SES. To design effective early interventions, it is crucial to understand the nature of these beliefs through genuine listening and active participation of children in research studies.

Teaching Machine Learning to Middle and High School Students from a Low Socio-Economic Status Background

Knowledge about Machine Learning is becoming essential, yet it remains a restricted privilege that may not be available to students from a low socio-economic status background. Thus, in order to provide equal opportunities, we taught ML concepts and applications to 158 middle and high school students from a low socio-economic background in Brazil. Results show that these students can understand how ML works and execute the main steps of a human-centered process for developing an image classification model. No substantial differences regarding class periods, educational stage, and sex assigned at birth were observed. The course was perceived as fun and motivating, especially to girls. Despite the limitations in this context, the results show that they can be overcome. Mitigating solutions involve partnerships between social institutions and university, an adapted pedagogical approach as well as increased on-by-one assistance. These findings can be used to guide course designs for teaching ML in the context of underprivileged students from a low socio-economic status background and thus contribute to the inclusion of these students.

Unequal selves in the classroom: Nature, origins, and consequences of socioeconomic disparities in children's self-views.

Children from low socioeconomic status (SES) backgrounds often have more negative self-views than their peers. How are these self-views shaped by teacher-student interactions in the classroom, and what are the consequences of these self-views for achievement inequality? We present a developmental framework addressing these questions by bridging insights from the psychological, educational, and sociological literatures. We show that children from low-SES backgrounds perceive themselves as less intelligent, less able to grow their intelligence, less deserving, and less worthy, independent of their actual abilities and achievements. We demonstrate how negative intellectual stereotypes-expressed through daily interactions with teachers in classrooms, such as teachers' expectations, feedback, and attention-undercut the self-views of children from low-SES backgrounds. We also show how this process can be exacerbated by institutional and cultural values reflecting a belief in meritocracy (e.g., schools that encourage competition, emphasize raw ability, and attribute achievement inequality to intrinsic factors), which are common in countries with high income inequality and rigid between-school tracking. The ensuing more negative self-views introduce psychological barriers that undermine the academic achievement of children from low-SES backgrounds, thereby reinforcing achievement inequality. This represents an enormous loss of potential and perpetuates harm into adulthood. Socioeconomic disparities in self-views can emerge early in life and widen with age, underlining the need for developmental research and timely intervention. We discuss implications for studying the nature, origins, and consequences of socioeconomic disparities in self-views, and for designing interventions to reduce achievement inequality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Disparities in Continuous Glucose Monitor Use Between Children With Type 1 Diabetes Living in Urban and Rural Areas.

Despite evidence that continuous glucose monitoring (CGM) use is associated with lower HbA1c among children with type 1 diabetes, uptake of this technology remains lower among those with difficulty accessing health care, including those from lower socioeconomic status backgrounds and racial and ethnic minorities. In this study, we sought to explore the impact of rural location in use of CGM technology to guide patient and provider decision making. In this retrospective study of electronic health record demographic and visits data from a single diabetes program from 1 January 2018 through 31 December 2021, we compared the odds of completing a visit with (+) and without (-) CGM interpretation between rural-urban commuting area (RUCA) designations. Among the 13,645 visits completed by 2,008 patients with type 1 diabetes younger than age 18 years, we found children living in small rural towns had 31% lower odds (6.3% of CGM+ visits, 8.6% of CGM- visits; adjusted odds ratio [aOR] 0.69, 95% CI 0.51-0.94) and those living in isolated rural towns had 49% lower odds (2.0% of CGM+ visits, 3.4% of CGM- visits; aOR 0.51, 95% CI 0.28-0.92) of completing a CGM-billed clinic visit compared with those living in urban areas (70.0% of CGM+ visits, 67.2% of CGM- visits). We also found significant differences in CGM-billed visits by neighborhood deprivation as well as race/ethnicity and insurance payor. Geographic location presents a meaningful barrier to access to care for patients living with type 1 diabetes. Further work is needed to identify and address the needs of children and families living in rural areas to improve the care of these patients.

Why Do People Think Individuals in Poverty Are Less Vulnerable to Harm?: Testing the Role of Intuitions About Adaptation.

People often falsely believe that individuals from low socioeconomic status (SES) backgrounds are less harmed than those from higher SES backgrounds by a wide range of negative events. We report three studies (total N = 1,625) that provide evidence that this "thick skin bias" emerges at least in part because people overgeneralize otherwise accurate intuitions about adaptation. Across studies, participants accurately intuited that people adapt to psychophysical experiences (e.g., brightness, weight, and volume) but also inaccurately intuited that people similarly adapt to life hardships that actually tend to exacerbate the harm of future negative events. Experimentally decreasing the salience of psychophysical adaptation intuitions reduced the thick skin bias, suggesting a causal link between these adaptation intuitions and the belief that people in poverty are less vulnerable to harm and underlining the importance of studying how biased beliefs about the effects of poverty may perpetuate inequality.

All Else Being Equal: Examining Treatment Bias and Stereotypes Based on Patient Ethnicity and Socioeconomic Status With In-Hospital Cardiac Arrest Clinical Vignettes

BackgroundResearch on ethnic and socioeconomic treatment differences following in-hospital cardiac arrest (IHCA) largely draws on register data. Due to the correlational nature of such data, it cannot be concluded whether detected differences reflect treatment bias/discrimination – whereby otherwise identical patients are treated differently solely due to sociodemographic factors. To be able to establish discrimination, experimental research is needed. ObjectiveThe primary aim of this experimental study was to examine whether simulated IHCA patients receive different treatment recommendations based on ethnicity and socioeconomic status (SES), holding all other factors (e.g., health status) constant. Another aim was to examine health care professionals’ (HCP) stereotypical beliefs about these groups. MethodsHCP (N = 235) working in acute care made anonymous treatment recommendations while reading IHCA clinical vignettes wherein the patient's ethnicity (Swedish vs. Middle Eastern) and SES had been manipulated. Afterwards they estimated to what extent hospital staff associate these patient groups with certain traits (stereotypes). ResultsNo significant differences in treatment recommendations for Swedish versus Middle Eastern or high versus low SES patients were found. Reported stereotypes about Middle Eastern patients were uniformly negative. SES-related stereotypes, however, were mixed. High SES patients were believed to be more competent (e.g., respected), but less warm (e.g., friendly) than low SES patients. ConclusionsSwedish HCP do not seem to discriminate against patients with Middle Eastern or low SES backgrounds when recommending treatment for simulated IHCA cases, despite the existence of negative stereotypes about these groups. Implications for health care equality and quality are discussed.

Association Between Socioeconomic Status and Prevalence of Hypersensitivity Diseases and Autism: A Nationwide Study of Children.

Prior research suggests that children with a low socioeconomic status (SES) background are at an increased risk for special healthcare needs. Conversely, for hypersensitivity-related diseases, many studies reported a lower risk among children with lower SES according to the hygiene hypothesis. We aimed to evaluate the association between SES and several hypersensitivity diseases and autism in a representative American sample. We used data from the 2016, 2017 and 2018 US National Survey of Children's Health. A total of 102,341 children aged 0-17 years were included. The dependent variables were doctor-diagnosed allergies, arthritis, asthma, diabetes, and autism. The main SES indicators were family poverty levels, highest education of the reported adults and difficulty in family income. Our analysis used logistic regression that accounted for the survey sampling design. The sample had a mean age of 9.4 ± 5.3 years. The weighted prevalence for allergies was 24.4%, 0.3% for arthritis, 11.9% for asthma, 0.5% for diabetes and 2.6% for autism. Children with adults reporting higher educational levels had greater odds of allergies (adjusted odds ratio and 95% CI: 1.48, 1.23-1.78) than those with lower educational levels. But for all other diseases, most findings suggested that a higher odds of disease was associated with lower SES instead of higher SES. A low SES background remains an important risk factor for hypersensitivity diseases in children. Most of our results suggested that children with low SES were associated with a higher risk of hypersensitivity diseases and autism.

“You did incredibly well!”: teachers’ inflated praise can make children from low-SES backgrounds seem less smart (but more hardworking)

Can teachers’ inflated praise make children from low socioeconomic status (SES) backgrounds seem less smart? We conducted two preregistered experiments to address this question. We used hypothetical scenarios to ensure experimental control. An experiment with primary school teachers (N = 106, ages 21–63) showed that when a child from a low-SES (vs. high-SES) background succeeded in school, teachers attributed this success more to hard work and delivered more inflated praise (e.g., “You did incredibly well!”) but less modest praise (e.g., “You did well!”). An experiment with primary school children (N = 63, ages 10–13) showed that when children learned that another child received inflated praise (while an equally performing classmate received modest praise or no praise), they perceived this child as less smart but more hardworking. These studies provide converging evidence that teachers’ inflated praise, although well-intentioned, can make children from low-SES backgrounds seem less smart, thereby reinforcing negative stereotypes about these children’s academic abilities.

Health disparities in the detection and prevalence of pediatric obstructive sleep apnea

IntroductionPediatric Obstructive Sleep Apnea (OSA) is associated with negative health outcomes, behavior problems, and poor academic performance when left untreated. Prior research has shown that children from racial and ethnic minority backgrounds and those living in lower socioeconomic status (SES) homes or neighborhoods have higher prevalence of OSA but lower likelihood of receiving evidence-based care for OSA. Disparities in pediatric OSA detection (e.g., timely assessment and diagnosis) likely contribute to this observed inequity in receiving treatment. A polysomnogram (PSG) is the gold standard for diagnosing OSA but completing PSG can be challenging. Study aims were to examine racial, ethnic, and SES differences in (1) OSA prevalence and severity and (2) OSA detection, specifically PSG completion rates, timing since referral, and age of diagnosis.MethodsChildren (aged 1–18, N = 1,860, 56% male) were referred for PSG during a 6-month period. Participants' racial/ethnic background were as follows: 64.8% White non-Hispanic, 23.5% Black non-Hispanic, 9.4% White Hispanic, and 2.4% other. Children predominantly had Medicaid insurance (64.5%). SES was measured by insurance type and neighborhood SES using the Distressed Communities Index (DCI) for each participant's zip code (Economic Innovations Group; https://eig.org/dc). Covariates included child age and sex, BMI, premature birth status, and smoke exposure in the home.ResultsWe replicated previous research by showing that children from minority racial/ethnic backgrounds and lower SES backgrounds had higher prevalence rates of OSA and worse disease severity. Across racial, ethnic, and socioeconomic backgrounds, only 31.6% of the children referred successfully completed PSG. Insurance coverage (Medicaid or private vs. self-pay), was an important factor in predicting earlier timing and better completion rates of PSG, which is essential for successful diagnosis and treatment of pediatric OSA.