Parental Concern Research Articles

Modern parenting: An ethical way to nurture children in digital era

The internet becoming more sophisticated and advancing at a tremendous rate is also a concern for parents. As children are introduced to the online platform, parents worry about their safety and nurture them from potential risks. Parents gradually develop their parenting methods in this era by learning from community websites, blogs, social media, and apps. The information equips them to deal with their children when playing with electronic devices or surfing websites. There are various types of Parenting Styles, from strict about precluding parenting. When parents are strict, they will be using technology that can monitor or track their children's activities by remotely accessing their children's device, camera, recording text messages, and locations. This type of parenting does make their children feel very uncomfortable. On the other hand, not being concerned about their children accessing the internet can be very dangerous as they can access any sites that are not allowed for their age. This article will review previous Digital Parenting experiences and analyze/design a solution around what parents should do when nurturing and guiding their children for a better future in this digital age.

Impact of skin conditions of infants on their mothers’ quality of life

Many parents worry about their infants' skin conditions, which can greatly impact their quality of life (QOL). This is applicable even to skin problems that are not severe enough to require medical intervention. This study aimed to explore the impact of infants' skin problems on their mothers' QOL depending on the type of the problems. Mothers' QOL was measured using the Dermatitis Family Impact questionnaire (DFI), and a DFI score of 2 or higher was defined as impacting mothers' QOL. A total of 143 mothers believed their infants had skin problems and completed the DFI. Twenty-eight mothers (19.6%) of infants with eczema had an impacted QOL. Diaper dermatitis and facial skin problems significantly affected mothers' QOL (p = 0.042 and 0.031, respectively). In conclusion, diaper dermatitis and facial skin problems in infants can affect mothers’ QOL. Pediatric and perinatal health professionals should consider such impacts and provide support and reassurance to parents.

Prevalence and perinatal risk factors of parent-reported colic, abdominal pain and other pain or discomforts in infants until 3months of age - A prospective cohort study in PreventADALL.

To estimate the prevalence and perinatal risk factors associated with parent reported colic, abdominal pain and pain or other discomforts in infants until 3months of age. Infant colic is a common concern for parents and clinicians. The prevalence varies in different studies and its symptoms overlap with other conditions like abdominal pain and discomfort. Diagnosis criteria are challenging, pathogenesis unclear and risk factors are conflicting. This was a prospective cohort study. The 1852 mother-child pairs from the PreventADALL prospective birth-cohort answering the 3months questionnaire were included. Information on perinatal risk factors was collected from the inclusion visit and questionnaires during pregnancy at 18 and 34weeks, as well as birth charts. STROBE checklist was followed. The reported prevalence of colic was 3% (59/1852), abdominal pain 22% (415/1852) and pain or other discomfort 6% (119/1852), with a total of 26% (478/1852) infants. Mothers on sick leave in pregnancy and reporting any allergic diseases had a significantly higher odds of reporting infant colic, abdominal pain and pain or other discomforts. Mothers with higher perceived stress in pregnancy exhibited a trend towards higher odds for reporting infant pain. Mothers coming from Sweden were less likely to report infant abdominal pain compared to mothers from Norway. The prevalence of abdominal pain and pain or other discomforts was higher than the prevalence of colic. Perinatal risk factors connected to maternal health were associated with all three symptoms. Colic and abdominal pain are stressful, symptoms overlap and risk factors for both can be identified in pregnancy. Our study suggests that it is difficult for parents to distinguish among infant colic, abdominal pain and other pain or discomfort and some report two or all three symptoms. Identifying the perinatal risk factors associated with infant pain may help target and support parents.

Association between Parents' Perceptions of Preschool Children's Weight, Feeding Practices and Children's Dietary Patterns: A Cross-Sectional Study in China.

Parental perception of children’s weight may influence parents’ feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents’ perceptions of child weight, feeding practices and preschoolers’ dietary patterns. Participants (1616 parent-child pairs) were recruited from six kindergartens in Hunan, China. Parents’ misperception, concern, and dissatisfaction on child weight were collected through a self-administered caregiver questionnaire. Parental feeding practices and children’s dietary intake were, respectively, assessed using the Child Feeding Questionnaire and a Food Frequency Questionnaire. Linear regression models were applied to analyze associations between parental weight perceptions, feeding practices, and preschooler’s dietary patterns. Associations between parents’ weight perceptions and dietary patterns were significant only among underweight children. Regardless of child weight status, parental weight underestimation and preference for a heavier child were positively associated with pressure-to-eat. Parental weight concern was positively associated with restriction in normal weight child, but this was not found in other weight groups. In conclusion, Parents’ misperception, concern, and dissatisfaction about child weight are associated with parents’ feeding practices and may influence preschoolers’ dietary quality, but the relationships vary by children’s actual weight status.

Parental mediation in pandemic: Predictors and relationship with children's digital skills and time spent online in Ireland

During the COVID-19 pandemic, an increasing reliance on digital technology to carry out social, entertainment, work and school activities increased, which may have affected the ways in which parents mediated their children's digital technology use. Given the prominent role that digital technology will have in the future, it is important to investigate parent and child characteristics which impacted parental mediation of children's digital technology use. Therefore, the present study aimed at analysing the frequency of parental mediation strategies (i.e. active and restrictive) during lockdown, their determinants, and how the two strategies affected children's digital skills and time spent online. Data were collected from 461 parent and 461 child participants. Results showed that almost half of parents (46%) practiced parental mediation with the same frequency, while the 42.6% applied it more often. Active mediation was predicted by parental worries about online risks, while restrictive mediation was predicted by time spent online by children, parental worries about online risks, parental negative attitudes towards digital technology and parents' digital skills. Children developed more digital skills when their parents applied higher levels of both active and restrictive mediation, and they spent the lowest amount of time online when their parents employed higher levels of restrictive and lower levels of active mediation. Practical implications for families and children's wellbeing are discussed.

Separating Fact from Fiction in the Diagnosis and Management of Food Allergy

Separating Fact from Fiction in the Diagnosis and Management of Food Allergy

The Effect of Oral Motor Therapy on Feeding Difficulties and Eating Behaviors in Younger ASD Children

Background: A variety of feeding difficulties like aversion of food, food selectivity, complete food refusal are the most common problems reported by the Parents of ASD children. Every parent of ASD children struggles to manage their child’s feeding routine as well as undesirable mealtime behaviours, which can cause parental concern and poor family dynamics.
 Aim: 1) The aim of this study is to analyze the effect of dedicated oral motor work in children with ASD who presented with feeding difficulty. 2) To determine parental concerns related to feeding behavior shown by their child and assess whether an additional home program in parallel with oral motor work by an Occupational Therapist would provide any benefits.
 Methods: This is a pre and post study where a total number of 18 ASD children at the age of 2-4 year old were participated and selected through BPFAS, out of which 15 copies were considered to be concerned with the oral motor and feeding difficulties of the child. Therefore, 15 participants who were facing feeding difficulties with their children were recruited. Concerned Participants were further assessed by Occupational therapist with the help of ‘The com deall Oro-motor assessment scale for toddlers’.
 Results: According to The Com Deall Oral-motor assessment scale, some changes observed in the oral motor skills and When parental concern is considered via home plan including mealtime strategies with oral motor activities, the post intervention result showed decrease in Total problem score as well as in Total frequency score.
 Conclusion: The study concluded that continuous structured direct oral motor work as well as addressing parental concerns via home programs is helpful for the ASD children and gives better understanding of feeding difficulties to their parents. Also, some changes have been seen in oral motor skills through continuous practice of oral motor activities by the therapist.

Multimedia Based Sign Language Learning

Having children with hearing impairment is a great concern for parents in teaching their children to communicate. However, parents tend to have trouble choosing the right approach in teaching children with hearing impairment to not feel lazy and bored quickly in learning. This research aims to create an interactive sign language learning application based on the BISINDO sign language system as an alternative learning media for children with hearing impairment to increase their learning motivation. The application was made to support children with hearing impairment in understanding sign language, starting from recognizing letters, numbers, basic and greeting words; the application was also made as an interactive software equipped with various supporting features such as videos, animations, to trivia quizzes. This research used descriptive methods with observation and interviews, as well as prototype methods in system development. This study indicates that the application can increase learning motivation for children with hearing impairment and provide supporting instruments for parents in teaching children to communicate. In conclusion, the application is beneficial and has a solution for parents to teach sign language to their children who have a hearing impairment and difficulty digesting learning and lack motivation

Meckel's Masquerade: Penetrating the Disguise.

Children with abdominal pain are frequently seen in emergency departments. Physicians and parents worry about appendicitis; physicians are also concerned about intussusception and bowel obstruction in patients with previous surgical procedures. Sometimes the patient is ill, and the diagnosis is elusive. In a 6-month period at our pediatric emergency department with an annual census of 57,400 patients, we cared for 4 patients who presented with abdominal pain due to complications of Meckel's diverticulum. None presented with painless rectal bleeding, the complication of which physicians are most aware. We are reporting these patients to raise awareness of Meckel's diverticulum as a cause of acute abdomen in children. Meckel's diverticulum may masquerade as appendicitis, an abdominal mass, intussusception, or a complication of severe constipation.

6.2 Evaluation of an Artificial Intelligence–Based Medical Device Designed to Aid in the Diagnosis of Autism Spectrum Disorder in the Primary Care Setting

The lack of diagnostic tools for autism spectrum disorder (ASD) in primary care settings and long waiting lists for specialist assessment contribute to an average delay of 3 years between first parental concern and diagnosis. This study examined the performance of an artificial intelligence–based device intended to aid primary care practitioners (PCPs) in the diagnosis of ASD. This was a prospective multisite pivotal study conducted in 6 states using a double-blind active comparator design with 425 completed subjects (36% female) ages 18 to 72 months with concern for developmental delay. Previous research developed, tuned, and tested a device that uses a gradient-boosted decision-tree machine learning algorithm that analyzes 64 behavioral features from 3 distinct inputs: 1) caregiver questionnaire; 2) 2 to 4 minutes of home videos analyzed by trained video analysts; and 3) PCP questionnaire. Device results were compared to diagnosis by independent agreement of specialist clinicians based on clinical assessment, including a modified Child Autism Rating Scale (CARS-2) and DSM-5 criteria. Specialists were child and adolescent psychiatrists, child psychologists, pediatric neurologists, and developmental behavioral pediatricians experienced in diagnosing ASD. Comparison of device results to specialist diagnosis found the following for subjects with determinate device results: positive predictive value (PPV) = 80.8% (95% CI, 70.3-88.8); negative predictive value (NPV) = 98.3% (90.6-100); sensitivity = 98.4% (91.6-100); and specificity = 78.9% (67.6-87.7). There was no evidence that device performance significantly varied when the PCP used the device remotely compared to in-person. Using this device, PCPs could efficiently, accurately, and equitably diagnose a subset of children aged 18 to 72 months old, thereby streamlining specialist referrals and facilitating earlier ASD diagnosis and interventions. The results further provide preliminary evidence that PCP evaluation of the child can be done via telemedicine or in-person with no degradation in device performance.

Relationship between Stress and Feeding Behaviors in Parents of Children with Developmental Disabilities.

Background: Controlling feeding practices are associated with negative child eating behaviors and an increased risk of obesity. Parental stress may be related to feeding practices. Children with developmental disabilities have increased obesity prevalence, and families may also experience increased stress. This study examined the relationship between family stress and parental feeding practices in children with developmental disabilities and how concern for the child's weight may moderate this relationship. Methods: Secondary analysis using a descriptive cross-sectional design was employed. Parents of children aged 5 to 15 years, with autism spectrum disorder (ASD), Down syndrome (DS), or spina bifida (SB) were recruited nationally. Demographics, the Child Feeding Questionnaire, and the Questionnaire on Resources and Stress were completed online. Analysis included regression with an empirical Bayesian effects model. Results: Five hundred twenty-three parents, 186 (ASD), 173 (DS) and 164 (SB), participated. Family stressors were associated with the use of controlling feeding practices. Direct effects included: (1) physical incapacitation on restriction and pressure to eat (ASD and DS); (2) pessimism (ASD) and concerns about child overweight (SB) on pressure to eat; and (3) parent/family problems on restriction (DS). Concern for child overweight moderated these relationships and resulted in two interactions (DS and SB). Conclusion: Understanding the relationship of family stressors with parental feeding practices and the role of parental concern for child overweight can potentially optimize feeding in this high-risk population. This study highlights the need to provide family-centered care with awareness of stress and its potential association with daily activities and children's health.

Beyond COVID-19 Pandemic: How Did Interaction Balances Change Between Children and Caregivers

We are going through hard times that remind us that good health is the most important thing in life. The COVID-19 pandemic has immensely affected everybody. Measures taken by all countries, including Turkey, to prevent the spread of the coronavirus have deprived students (from preschool to university) of face-to-face education. While the pandemic has had a profound impact on parents and educators, children's lives have been stuck between the “new normal” and the pandemic. This paper investigated how children and their parents experienced the pandemic, how they interacted, and managed educational activities at home. This was a case study, which is a qualitative research method. The sample consisted of 15 families with different sociocultural and socioeconomic status (SES) living in five cities in four regions of Turkey. Data were collected through video-audio recordings, observation notes, and e-interviews. Data were analyzed using second-cycle coding and inductive content analysis. The COVID-19 pandemic caused economic problems, especially in low- and middle-SES families. Economic problems and mental stress impeded the marital interaction patterns of couples, negatively affecting children the most. Upper-SES parents received support from teachers for homeschooling, but other parents faced numerous setbacks and made numerous errors during home-based education, causing parents despair and concern for their children's future. Of all participants, the children of the parents with COVID-19 related health problems were affected by outbreak measures the most. These results can help raise all stakeholders' awareness of the current situation. Given that the COVID-19 pandemic may continue for the foreseeable future, it is believed that the suggestions made to parents and educators for homeschooling can help mitigate the future impacts of the pandemic, especially on preschoolers.

Inclusive Practices in the Existing School Environment: Parental Perceptions and Concerns

Purpose: This qualitative research paper explores the factors affecting parental perceptions and concerns about inclusive education. It also investigates the factors influencing the access and participation of children with disabilities in mainstream schools.
 Design/Methodology/Approach: Ten parents (n=10) of children with and without disabilities were selected through purposive sampling from inclusive primary schools of Punjab. Semi-structured interviews and thematic analysis were employed for data collection and analysis.
 Findings: Findings revealed that parents of children with disabilities are more inclined towards inclusive education. Reactions of parents, quality of instruction and institutional support have created a feeling of un-certainty and dissatisfaction amongst the parents of children with disabilities about inclusion. Large class sizes and time constraints have been established as barriers to inclusion.
 Implications/Originality/Value: The study would be beneficial for the school department to consider the factors adversely affecting the process of inclusion. Parents’ guidance and counselling may be made mandatory to make inclusive education successful.

NALISIS PROBLEMATIKA STUDY FROM HOME (SFH) PADA MATA PELAJARAN BAHASA INGGRIS DI SMP NEGERI 1 RANAH PESISIR KABUPATEN PESISIR SELATAN MASA PANDEMI COVID-19

The policy issued by the government regarding study from home during the COVID-19 pandemic has created new problems in learning in schools. Students assume that study from home is a holiday activity that they enjoy at home. This kind of learning also causes students to feel bored because every day they face very monotonous activities. This study aims to describe the problems of pedagogy with study from home (SFH) in learning English at SMP Negeri 1 Ranah Pesisir during the COVID-19 pandemic. This study uses a qualitative descriptive method with a case study approach. As the subject of this research, four English teachers teach grades VII, VIII and IX at SMP Negeri 1 Ranah Pesisir. From the data analysis, the researchers obtained the results, namely, 1) the absence of online study from home learning training, so that teachers still lacked experience in improving online SFH learning activities. 3) Limited time with SFH online makes students unable to complete school assignments on time. 4) Lack of parental concern for students because parents are still pretentious with the online SFH learning system, they are not used to being involved in the learning process.

Pediatric Otolaryngology During COVID-19: Parental Concern About Elective Surgery.

To identify the concerns of parents whose children may need elective surgery during the COVID-19 pandemic. In December 2020, parents of pediatric otolaryngology patients were recruited for a survey about concerns related to elective surgery during the COVID-19 pandemic. A Likert scale quantified concern. The 1 was anchored "Not at all important" and 5 was "Most important." Demographics included gender, age, race, education level, number of children in household, and whether their child had surgery since March 2020. About 253 participants were included. Medians ranged from 1 for concerns about emotional and family support to 4 for concerns about their child being exposed to COVID-19 in the Emergency Room. Black parents were more concerned about the risks of COVID than White parents; they were more concerned about their child contracting COVID-19 during surgery compared to White parents, median was 4 versus 3 (P = .027). Black parents had a median score of 3 for concern about medical expenses compared to a median of 2 (P = .001). Parents of children who had surgery since March 2020 had less concern about their child being exposed to COVID-19 during hospitalization (P = .045) and less concern about critique from others (P = .024). Parents were most concerned about the risk of seeking Emergency Room care. Black parents were generally more concerned about having their child undergo elective surgery. Whether this is translated into fewer Black children undergoing important but elective surgery requires more study.

Psychosocial Impact of Coronal Access Scars in Craniosynostosis Procedures on Patients and Their Families.

The coronal incision is the mainstay for access in craniosynostosis surgery. Scarring is a common concern of parents whose children are offered an open procedure. To the author's knowledge, there are no previous studies looking at the psychosocial impact of scarring from coronal access incisions for craniosynostosis procedures. The author's study focused on patients undergoing procedures for nonsyndromic single-suture craniosynostosis.This study comprised 3 parts: worldwide survey regarding coronal access incisions for craniosynostosis surgery, questionnaire to determine the psychosocial impact of the scars on patients and their parents, and measurement of postoperative scars in craniosynostosis patients.Survey responses from 46 craniofacial centers worldwide revealed a zig-zag was the most commonly utilized incision. Seventy-two percent of survey responses reported problems with postoperative stretching of the scar; only 20% of centers reported formal data collection of whether families were affected by this.Psychology questionnaires revealed that the majority of patients and their parents were not bothered by the zig-zag coronal scars. Patient felt the scars were less noticeable than the parents. Parent perceptions improved with age and time postsurgery.Coronal access scars following craniosynostosis surgery appear to stretch more in the supra-auricular region compared with the midline.These findings are useful for the craniofacial multidisciplinary team to inform parents contemplating surgery and who may be concerned about the impact of the scar in the future.

Brief Report: A Cross-Sectional Study of Anxiety Levels and Concerns of Chinese Families of Children With Special Educational Needs and Disabilities Post-first-wave of COVID-19

The COVID-19 pandemic has a multifaceted impact on mental health due to ill health, restrictions and lockdowns, and loss of employment and institutional support. COVID-19 may disproportionally impact families with special educational needs and disabilities (SEND) due to the already higher prevalence of mental health conditions in children with SEND and their parents. Therefore, it is essential to determine the short-term impact of the pandemic on the mental health of families with SEND in order to identify their ongoing health support needs. The current study aims to examine the anxiety level and concerns of children with SEND and their parents living in China. The sample consisted of 271 parents of children with SEND aged between 6 and 17 years (Mage = 8.37; SDage = 2.76). Parents completed an online survey between 10 April to 8 June 2020. Both child and parental anxiety levels and various concerns increased after the initial wave of COVID-19 when compared with retrospective pre-COVID-19 levels. Parental anxiety and concern levels were significantly higher for those living in rural areas compared to urban areas. In addition, parental and child anxiety and concern levels were significantly correlated with each other. Parental anxiety at the lowest level made a unique and significant statistical contribution to children's anxiety levels. The implications of the study findings are discussed.

DMD/BMD - GENETICS: EP.116 Establishing clinical and genetic characteristics in young, glucocorticoid-naïve boys with Duchenne muscular dystrophy: the FOR DMD study

We describe the clinical characteristics and genetic profile of a large sample of young glucocorticoid-naïve boys with Duchenne muscular dystrophy (DMD). Screening and baseline data were collected for participants in the FOR-DMD study, an international, multi-centre, randomized, double-blind clinical trial comparing 3 commonly prescribed glucocorticoid regimens in untreated DMD boys with a confirmed genetic diagnosis of DMD between 4 and < 8 years of age. One hundred ninety-six boys were recruited in the study. The mean age at randomization was 5.9 (standard deviation, SD 1 year). The most frequent mutation type was out of frame deletions (130/193, 67.3%) of which 68.5% (89/130) were amenable to exon skipping. Mutations amenable to exon 51 skipping were the most frequent (n=25). Stop codon mutations were reported in 19/193 boys (10%). The mean age of parental concern was 29.8 months (SD 18.7); the mean age of genetic diagnosis was 50.3 months (SD 23.8). The mean ages at independent walking and talking in sentences were 17.1 (SD 4.2) and 29.0 (SD 10.7) months, respectively. Pre-steroid median height and weight were below the 50th percentiles regardless of age group. Boys with exon 8 skippable deletions performed better in time to walk/run 10 meters compared to boys carrying other out of frame deletions not amenable to skipping (4.8±0.7 vs 6.3±4 seconds, p 0.001). Boys with exon 53 skippable deletions showed a lower baseline performance in the 6-minute walk test compared to boys with other out of frame deletions not amenable to skipping (308.9±61 vs 342±46 metres, p 0.003). In conclusion, this study describes clinical, genetic, and anthropometric characteristics of a sample of young glucocorticoid-naïve boys with DMD. Some genotype-phenotype associations were identified. These findings characterise a baseline pre-steroid cohort and, with the longitudinal data to follow, will help to inform eligibility criteria and outcome measures for future clinical trials in DMD.

The influence of race on parental beliefs and concerns during an autism diagnosis: A mixed-method analysis.

The goal of this study was to examine if there were differences between races in parental concern and belief about autism spectrum disorder (ASD) and the perspectives of clinicians. We studied 489 children with ASD who were having their first evaluation at an ASD clinic. Parents of White children most often believed that their child had ASD. However, White children whose parents believed the child had ASD were less severe in their symptoms. Parents of Black/African American or Hispanic children were more likely to have concerns about communication than parents of White children. In Hispanic families, parental concern about social communication was related to more severe symptoms in children. We discuss the implications of our findings for diagnosis.

Thinking ahead: Parents' worries about late effects of childhood cancer treatment.

Many childhood cancersurvivors experience at least one late effect of treatment, and both late effects and persistent cancer-related worry can negatively impact quality of life in survivorship. Little is known about the prevalence or impact of parental worry about late effects early in treatment. This study evaluated parental perceived likelihood, impact, and worry about late effects of childhood cancer. We surveyed 96 parents of pediatric cancer patients at Dana-Farber/Boston Children's Cancer and Blood Disorders Center within a year of diagnosis. Parents were asked about their experiences with late effects communication, general worry about late effects, and specific late effect worries. Most (96%) parents valued information about late effects, and 93% considered late effects in their treatment decision-making. Yet, 24% could not recall receiving any information about late effects, and only 51% felt well prepared for potential late effects. Though only 20% of parents considered their child at high risk of experiencing late effects, 61% were extremely/very worried about late effects. Those who felt their child was at high risk of experiencing late effects were more likely to worry (OR=4.7, P=0.02). Many parents feel inadequately informed about late effects of cancer treatment, and only one-fifth of parents consider late effects to be likely for their child. However, a majority of parents worry about late effects, including ones they think their child is unlikely to experience. Although some worry is anticipated, disproportionate worry may be mitigated by addressing both educational shortfalls and emotional concerns.