School Start Research Articles

The START study: An evaluation to study the impact of a natural experiment in high school start times on adolescent weight and related behaviors

Research has shown that early high school start times, which are asynchronous with adolescent biology, are one of the most significant obstacles to youth being able to net sufficient sleep. Given that adolescence is a critical period that sets the stage for long-term obesity risk behavior patterns, there is an need to understand the obesity-related implications of increased sleep as a result of intervention and policy changes. We evaluated a community-based natural experiment in school start time policy modification when several Minneapolis-St. Paul, MN metro area school districts shifted to later school start times in Fall 2016. We collected data on student weight and related risks (via paper survey, objective weight and height measurement, dietary recall, and sleep actigraphy) before and after two districts (two high schools) shifted their start times later and in a comparison district (three high schools) which kept their start times early (7:30am) through the course of the study. Our specific aims were: 1) Determine how a shift to a later high school start time relates to objectively measured weight change over time. 2) Identify the relationship between school start times and obesity-related behaviors over time.At baseline we had 2,133 returned surveys (93% participation) and 2,037 (86% participation) objective height/weight measurements from 9th grade students (class of 2019) in the five schools. The sample was 87.7% white, 12.8% reported qualifying for free/reduced price lunch (a measure of lower socio-economic status), and the mean age was 15.2 (SD=0.35) years. The products of this research will clarify causal connections between sleep and obesity among adolescents as well as provide evidence for whether a school start time policy can minimize unhealthy weight gain.

Supplemental Material for Trajectories of Anxiety When Children Start School: The Role of Behavioral Inhibition and Attention Bias to Angry and Happy Faces

Supplemental Material for Trajectories of Anxiety When Children Start School: The Role of Behavioral Inhibition and Attention Bias to Angry and Happy Faces

Sleep Disruptions and Disorders in Children and Adolescents: A Review of the Impact of Parents and Family on Sleeping Behaviors

While it is recognized that ensuring adequate sleep is vital in childhood development, typical activities, such television and other electronic media, early school start times, and extracurricular activities, can intrude on sleep time. Parents are faced with the responsibility of either limiting distractions and activities which interfere with sleep, or dealing with the complications of a child who does not receive adequate sleep. Some parents are not equipped with the knowledge of the amount of sleep children require. Certain parents also do not have discipline abilities to effectively manage their child's behavior to encourage sleep. Effective treatments are available for sleep disturbances in children, but often depend on a parent's ability to manage sleep behavior in their children. The following paper provides an overview of the significant literature published on sleep disturbances in children (early childhood through adolescence), along with the interrelationship between sleep and the family.

Does delaying school start time change sleep hours and tiredness of Korean adolescents?

Does delaying school start time change sleep hours and tiredness of Korean adolescents?

OKUMA YAZMA BİLEREK İLKOKULA BAŞLAYAN ÇOCUKLAR HAKKINDA İLKOKUL ÖĞRETMENLERİNİN GÖRÜŞLERİ

OKUMA YAZMA BİLEREK İLKOKULA BAŞLAYAN ÇOCUKLAR HAKKINDA İLKOKUL ÖĞRETMENLERİNİN GÖRÜŞLERİ VİEWS OF PRİMARY SCHOOL TEACHERS ON CHİLDREN WHO START SCHOOL HAVİNG LEARNED HOW TO READ AND WRİTE Öz Bu çalışma okul öncesi döneminde okuma yazma bilerek okula başlayan çocuklar hakkında ilkokul öğretmenlerinin görüşlerini ortaya çıkarmak amacıyla yapılmıştır. Çalışmada nitel araştırma yöntemlerinden durum çalışması kullanılmıştır. Araştırmanın çalışma grubu oluşturulurken katılımcıların seçilmesinde amaçlı ve kriter örnekleme yöntemlerinden yararlanılmıştır. Çalışma grubuna, Erzurum ili merkezinde ilkokul bünyesinde görev yapan 30 sınıf öğretmeni dahil olmuştur. Çalışma verileri 2016-2017 bahar yarıyılında toplanmıştır. Sınıf öğretmenlerinin okuma yazma bilerek ilkokula başlayan çocuklara ilişkin görüşlerinin alınmasında nitel bir araç olarak görüşme tekniği kullanılmıştır. Araştırmada nitel veri toplama aracı olarak araştırmacılar tarafından hazırlanmış yarı yapılandırılmış görüşme protokolü kullanılmıştır. Görüşme protokolü katılımcıların demografik bilgileri ile görüşlerinin alındığı sorular olmak üzere iki bölüm olarak tasarlanmıştır. Görüşmeler, öğretmenlerden randevu alınarak, okul ortamında uygun bir alanda, öğretmenlerin isteğine bağlı olarak ses kayıt cihazı yardımıyla ya da araştırmacının görüşme formuna yanıtları yazması yoluyla tamamlanmıştır. Verilerin tamamı bilgisayar ortamına aktarılmış ve her katılımcıya bir kod verilmiştir. Öğretmenlerin verdikleri yanıtlar betimsel analiz yöntemiyle incelenmiş ve yanıtlar ortak temalar altında birleştirilmiştir. Yapılan çalışmanın sonuçlarına göre öğretmenler, bu çocukların akademik olarak daha etkin olduklarının farkındadırlar. Ancak sınıf ortalamasına göre daha ileri düzeyde olmaları sıklıkla odaklanma ve motivasyon düşüklüğüne sebep olmaktadır. Bazı durumlarda ise öğretmenler okuma yazma bilen çocukları, akran rehberliğinde kullanarak var olan potansiyellerini farklı şekillerde değerlendirmektedirler. Anahtar Kelimeler: okuma yazma becerileri, okul öncesi dönem, ilkokul öğretmeni, ilkokuma-yazma. Abstract This study was conducted with the aim of determining the views of primary school teachers on children who start school having learned how to read and write in their preschool period. This study used the qualitative research method of case study. The sample was selected by the methods of purposive and criterion sampling. The sample included 30 form teachers who were employed at a primary school located at the center of the province of Erzurum in Turkey. The data were collected in the spring semester of the academic year of 2016-2017. As a qualitative tool, the method of interview was used to collect the views of the form teachers on students who start primary school as already literate. As the qualitative data collection tool, the study used the semi-structured interview protocol prepared by the researchers. The protocol included two sections as questions regarding the demographic information of the participants and questions about their views. The interviews were conducted by making an appointment with the teachers at a suitable space in the school environment and by taking audio-recordings or written notes based on the preference of the teacher. All the data were transferred to the computer environment and each participant was assigned a code. The responses of the teachers were examined with the method of descriptive analysis and the responses were collected under common themes. According to the results of the study, the teachers were aware that these children are academically more effective. However, their higher levels in comparison to the classroom average frequently leads to problems in concentrating, as well as low motivation. In some cases, the teachers used such children in peer guidance and utilized their existing potential in different ways. Keywords: reading and writing skills, preschool period, primary school teacher, emergent literacy.

Later school start times in a flexible system improve teenage sleep.

Sleep deprivation in teenage students is pervasive and a public health concern, but evidence is accumulating that delaying school start times may be an effective countermeasure. Most studies so far assessed static changes in schools start time, using cross-sectional comparisons and one-off sleep measures. When a high school in Germany introduced flexible start times for their senior students-allowing them to choose daily between an 8 am or 9 am start (≥08:50)-we monitored students' sleep longitudinally using subjective and objective measures. Students (10-12th grade, 14-19 y) were followed 3 weeks prior and 6 weeks into the flexible system via daily sleep diaries (n = 65) and a subcohort via continuous wrist-actimetry (n = 37). Satisfaction and perceived cognitive outcomes were surveyed at study end. Comparisons between 8 am and ≥9 am-starts within the flexible system demonstrated that students slept 1.1 h longer when starting school later-independent of gender, grade, chronotype, and frequency of later starts; sleep offsets were delayed but, importantly, onsets remained unchanged. Sleep quality was increased and alarm-driven waking reduced. However, overall sleep duration in the flexible system was not extended compared to baseline-likely because students did not start later frequently enough. Nonetheless, students were highly satisfied with the flexible system and reported cognitive and sleep improvements. Therefore, flexible systems may present a viable alternative for implementing later school starts to improve teenage sleep if students can be encouraged to use the late-option frequently enough. Flexibility may increase acceptance of school start changes and speculatively even prevent delays in sleep onsets through occasional early starts.

Newly arrived refugee parents in Sweden and their experience of the resettlement process: A qualitative study

Aims: The Swedish public support system for the integration and establishment of newly arrived refugees includes an individualized introduction plan, containing language, civic and health information classes. As the plan requires active involvement, the simultaneous establishment of childcare and school start for children risks creating additional challenges and frustrations. The aim of the study was to explore the experience of adjustment among newly arrived refugee parents in the resettlement process, so as to understand how this risk may be mitigated. Methods: This paper presents findings from a qualitative study conducted with 24 Syrian refugee parents participating in the resettlement process and having received asylum status. Results: Parents experienced stress due to long waiting times for residence permits and the struggle to find stable housing. The parents established themselves by enrolling in language studies and looking for employment. They also faced challenges adjusting socially since they were mainly meeting people from their own country and, therefore, felt excluded from the Swedish society. Conclusions: The parents describe the experiences of having escaped from a war-torn country and arrived in new surroundings as mainly challenging for their current situation. Feelings of uncertainty arise as families struggle with daily life while waiting for residence permits, finding stable housing, learning a language and adjusting to new social circumstances. Having this in mind, we conclude that this group of refugees is exposed to health risks in the near future and, as such, is in need of additional support.

The Relationship Between Non-symbolic and Symbolic Numerosity Representations in Elementary School: The Role of Intelligence.

This study aimed to estimate the extent to which the development of symbolic numerosity representations relies on pre-existing non-symbolic numerosity representations that refer to the Approximate Number System. To achieve this aim, we estimated the longitudinal relationships between accuracy in the Number Line (NL) test and “blue–yellow dots” test across elementary school children. Data from a four-wave longitudinal study involving schoolchildren in grades 1–4 in Russia and Kyrgyzstan (N = 490, mean age 7.65 years in grade 1) were analyzed. We applied structural equation modeling and tested several competing models. The results revealed that at the start of schooling, the accuracy in the NL test predicted subsequent accuracy in the “blue–yellow dots” test, whereas subsequently, non-symbolic representation in grades 2 and 3 predicted subsequent symbolic representation. These results indicate that the effect of non-symbolic representation on symbolic representation emerges after a child masters the basics of symbolic number knowledge, such as counting in the range of twenty and simple arithmetic. We also examined the extent to which the relationships between non-symbolic and symbolic representations might be explained by fluid intelligence, which was measured by Raven’s Standard Progressive Matrices test. The results revealed that the effect of symbolic representation on non-symbolic representation was explained by fluid intelligence, whereas at the end of elementary school, non-symbolic representation predicted subsequent symbolic representation independently of fluid intelligence.

Constructing a Russian-Language Version of the International Early Reading Assessment Tool

Successful adaptation of first-graders to school largely determines their subsequent educational attainment. In Russia as well as across the globe, there are few high-quality standardized assessment instruments providing comprehensive vision of what children know and what they can do when they start school. Large-scale evaluation of reading literacy is particularly challenging due to age-specific characteristics and the assessment format. This article outlines a step-by-step procedure of localizing a part of an international instrument iPIPS designed to measure early reading skills at the start of school and the progress made during the first school year, within the framework of Russian educational paradigm. Localization is understood as transformation of an instrument originally developed in another language (English in this case) so that it accounts for the cultural and linguistic characteristics of the target audience. The procedure included development of a Russian-language version of iPIPS and a series of studies to verify its construct validity. The process involved analyzing the linguistic characteristics of the original tasks, finding equivalent linguistic means in the Russian language, and designing Russian-language tasks identical to the original ones in terms of functionality. To verify construct validity of the localized instrument, we evaluated the psychometric properties of the scale, tested its reliability, and studied compliance of the task structure and hierarchy with the theoretical framework. The findings have revealed that large-scale local or regional tests administered using this localized assessment instrument may yield valuable data which can be further used for analysis of the current situation and informed decision-making in educational policy.

Sleep duration and eating behaviours in youth: a scoping review protocol

IntroductionDevelopmental alterations to the circadian rhythm, in combination with lifestyle changes (eg, changes in school start time, part-time employment), contribute to insufficient sleep among youth. Insufficient sleep is associated with...

School Start time change and motor vehicles crashes in adolescent drivers

School Start time change and motor vehicles crashes in adolescent drivers

Hypersomnolence in Children and Adolescents: Causes, Assessment, and Management

Hypersomnolence is common in children and adolescents and its etiology is multifactorial. Developmental changes in melatonin release and slower accumulation of sleep pressure lead to a preference for later sleep times, which conflicts with early school start times leading to increased daytime sleepiness. Although the most common cause of daytime sleepiness in children and adolescents is insufficient sleep, central disorders of hypersomnolence can also manifest in these age groups. Excessive sleepiness could also result from other disorders such as sleep apnea, psychiatric illnesses, and medication use. Hypersomnolence should be evaluated by careful history taking, and when necessary additional tests including actigraphy, polysomnography, and multiple sleep latency test may need to be performed. In this review, we discuss the prevalence of hypersomnolence in children and adolescents, common etiological factors, and assessment of excessive sleepiness. We also discuss management strategies for hypersomnolence. [ Psychiatr Ann. 2019;49(12):529–534.]

What Time Should Middle and High School Students Start School?

What Time Should Middle and High School Students Start School?

Parents still matter: the influence of parental enforcement of bedtime on adolescents’ depressive symptoms

The aim of the current study was to test a multilevel mediation model that examined how adolescent sleep duration might be linked to depressive symptoms via their daytime energy levels. Furthermore, the study examined how parents' enforcement of various types of bedtime rules predicted the duration of adolescent sleep. A total of 193 adolescent (ages 14-17; Mage = 15.7 years old, SD = .94; 54.4% female; 71% Caucasian) and parent dyads completed baseline, online surveys, and adolescents also completed online 7-day, twice-daily (i.e. morning and evening) reports of their sleep duration (morning diary) and their energy levels and depressive symptoms throughout the day (evening diary). Parents (Mage = 47.6 years old, SD = 5.4; 80% female) completed assessments of enforcement of bedtime-related rules (i.e. bedtime, cessation of electronic media usage, prohibiting afternoon/evening caffeine consumption). Multilevel modeling enabled the testing of the mediation model both at the between-person level and within individuals. Results suggested that adolescents' energy levels mediated the association between adolescents' sleep duration and depressive symptoms. Furthermore, both greater enforcement of bedtimes and later school start times predicted longer sleep durations for adolescents, and were indirectly associated with adolescents' depressive symptoms. These findings underscore the importance of adolescents obtaining sufficient sleep to support their mental health and suggest a critical point of intervention for preventing or decreasing insufficient sleep. Given the diverse threats to adolescents' sleep as well as adolescents' desire for greater independence, collaborative, autonomy-promoting bedtime limit-setting is recommended to support adolescents' well-being.

Sleep and Circadian Rhythms in Adolescence

The purpose of this review is to synthesize the current evidence regarding biological changes to the regulation of sleep-wake behavior in adolescence, summarize the impact of environmental factors (e.g., media use, school start times) on sleep, and discuss the implication of these biological and behavioral changes for adolescent emotional, physical, and cognitive development. Although our basic understanding of the sleep regulatory process in adolescence has not shifted in recent years, emerging findings highlight the influence of environmental factors (e.g., media use) on sleep behavior. Furthermore, a flurry of recent experimental studies has bolstered our understanding of the influence of short sleep on cognitive and emotional functioning. Despite these advances, longitudinal data elucidating whether there are maturational changes in the impact to sleep loss on adolescent development are largely absent. A confluence of biological and environmental factors leads to short and ill-timed sleep among adolescents. Given the importance of sleep for the cognitive, emotional, and physical health in adolescence, the high prevalence of sleep loss in this population represents a public health issue.

End-user perspectives to inform policy and program decisions: a qualitative and quantitative content analysis of lifestyle treatment recommendations by adolescents with obesity

BackgroundLifestyle modifications represent the first line of treatment in obesity management; however, many adolescents with obesity do not meet lifestyle recommendations. Given that adolescents are rarely consulted during health policy development and in the design of lifestyle interventions, their first-hand experiences, preferences, and priorities may not be represented. Accordingly, our purpose was to explore adolescents’ lifestyle treatment recommendations to inform policy and program decisions.MethodsConducted from July 2017 to January 2018, this study adhered to a qualitative, crosslanguage, patient-oriented design. We recruited 19 13–17-year-old adolescents (body mass index [BMI] ≥85th percentile) seeking multidisciplinary treatment for obesity in geographically and culturally diverse regions of Canada. Adolescents participated in one-on-one, in-person, semi-structured interviews in English or French. Interviews were audio-recorded, transcribed verbatim, managed using NVivo 11, and analyzed using quantitative and qualitative content analysis by two independent researchers.ResultsAdolescents’ recommendations were organized into five categories, each of which denotes health as a collective responsibility: (i) establish parental support within limits, (ii) improve accessibility and availability of ‘healthy foods’, (iii) limit deceptive practices in food marketing, (iv) improve accessibility and availability of varied physical activity opportunities, and (v) delay school start times. Respect for individual autonomy and decision-making capacity were identified as particularly important, however these were confronted with adolescents’ partial knowledge on nutrition and food literacy.ConclusionsAdolescents’ recommendations highlighted multi-level, multi-component factors that influenced their ability to lead healthy lifestyles. Uptake of these recommendations by policy-makers and program developers may be of added value for lifestyle treatment targeting adolescents with obesity.

School-based obesity prevention for busy low-income families-Organisational and personal barriers and facilitators to implementation.

Little research has targeted multiple-level barriers and facilitators in school-based parental support programmes. This qualitative study aims to describe barriers and facilitators, at organisational and personal levels, that teachers and parents in disadvantaged settings in Sweden perceived as influencing the implementation of the Healthy School Start II (HSS II) intervention. Data collection, analysis and interpretation were guided by the Consolidated Framework for Implementation Research (CFIR). Focus groups and interviews were conducted with 14 parents and ten teachers within the HSS II trial. Data were analysed using qualitative content analysis in a deductive step using the three CFIR domains-inner and outer setting, and personal characteristics-followed by an inductive analysis. The theme 'being on the same page-getting burdened teachers and parents to work on common ground' was found. Among teachers, barriers and facilitators were related to the structure of the schoolwork and curriculum, involvement from other staff and school management, the practical school workday, perception of high family needs but low parental interest, insufficient resources in the families, and teacher's personal knowledge, interests, and opinions about health and food. For parents, barriers and facilitators were related to the perceived family needs and resources, parents' health knowledge, consensus about healthy behaviours and ability to cooperate, and school involvement in health issues and the intervention. Interventions should facilitate parents' and teachers' work on common ground, with activities suitable for a stressful and burdensome workday and everyday life. This could be achieved by integrating evidence-based practices within school routines, and including activities that are practicable despite parents' stressful lives, and that increase parental consensus about promoting health. Strategies to increase involvement of parents in families with high needs are necessary. Also, this study suggests an expansion of the CFIR to capture the interface between different micro-level organisations, and account for several delivering/receiving organisations.

Maternal interpregnancy weight change and childhood overweight and obesity: findings from a UK population-based cohort

BackgroundMaternal obesity is a major risk factor for childhood obesity. Given the relatively intensive contact with health and care professionals following birth, the interpregnancy period provides an excellent opportunity to focus on preconception and family health. We examined the association between maternal interpregnancy weight change and overweight/obesity in the second child. MethodsWe used a population-based anonymised linked cohort of antenatal and birth records registered at University Hospital Southampton, Hampshire, UK (August, 2004–August, 2014) and child health records. Change in maternal interpregnancy body-mass index (BMI) was calculated as the difference between BMI (using measured weight) at the first antenatal appointment of each pregnancy. Records of the first two singleton live pregnancies for 6358 women were analysed. Second child's age-adjusted and sex-adjusted BMI at 4–5 years was used to define the outcome of overweight/obesity (≥85th centile). Generalised linear modelling was used to adjust for maternal age, ethnicity, educational qualification, infertility treatment, smoking, employment status, gestational diabetes, BMI at start of the first pregnancy, and interpregnancy interval, then adding second child's birthweight. Findings18·5% women (1175 of 6358) gained 3 kg/m2 or more and 29·0% (1842 of 6358) gained 1–3 kg/m2 between pregnancies. Unadjusted prevalence of second child overweight/obesity for mothers with 3 kg/m2 or more gain was 27·9% (328 of 1175) compared with 18·6% (427 of 2287) for mothers whose weigh remained stable between pregnancies (–1 to 1 kg/m2). Interpregnancy gain of 3 kg/m2 or more was associated with increased risk of childhood overweight/obesity (adjusted relative risk [aRR] 1·15, 95% CI 1·01–1·32). The relationship was attenuated on adjusting for birthweight of child 2 (1·09, 0·95–1 ·25). This pattern was similar in the subgroup who were obese at the start of their first pregnancy (1·34, 1·00–1·78 and 1·27, 0·96–1·69, respectively). There was no evidence of an association between the other weight change categories and the outcome after adjustment. InterpretationMany women gain a considerable amount of weight between their first and second pregnancies. Children of mothers who have started their second pregnancy with a considerably higher weight than their first were more likely to be overweight/obese at the start of primary school; however, this association was attenuated by accounting for birthweight, which may be on the causal pathway. FundingAcademy of Medical Sciences and the Wellcome Trust (grant number AMS_HOP001\\1060 to NAA). NAA is also in receipt of research support from and the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre.

Evaluation of vitamin D3 levels and morphotic parameters of blood in prematurely born children at six years of age

In Poland the preterm children, with the birth rate reaching 6.3%, constitute a serious medical problem. The system of specialistic clinics provides them with the multidisciplinary care for the first 3 years of life, including the monitoring of hematologic parameters in relation with anemia and osteopenia. The aim of this study was to assess the vitamin D3 level and morphotic parameters of blood in children who were prematurely born at the time when they are about to start school. The study was carried out in a group of 92 children, aged 6 years ±0.63, including 54 preterm children born at gestational age <32 weeks - and 38 full-term children. A basic anthropometric measures and assessment of morphotic parameters and the vitamin D3 level were assessed. Statistical analyses were carried out using Shapiro-Wilk W-test, Student’s t-test and Mann-Whitney U test. Preterm children had significantly lower the vitamin D3 level than controls. This also refers to some morphotic parameters of blood, such as level of hemoglobin, mean corpuscular hemoglobin concentration and platelets. Prematurely born 6–7 year-old children have significantly lower vitamin D3 levels in blood serum than normal and significantly lower hemoglobin levels than full-term children.

Ten-Year Secular Trends in Sleep/Wake Patterns in Shanghai and Hong Kong School-Aged Children: A Tale of Two Cities.

To compare the secular trends of sleep/wake patterns in school-aged children in Hong Kong and Shanghai, two major metropolitan cities in China with two different policies that school start time was delayed in Shanghai, but advanced in Hong Kong in 10 years' time. Participants were from two waves of cross-sectional school-based surveys of children aged 6 to 11 years. In Shanghai, 4,339 and 13,795 children participated in the 2005 and 2014 surveys, respectively. In Hong Kong, 6,231 and 4,585 children participated in the 2003 and 2012 surveys, respectively. Parents reported their children's bedtime and wakeup time, and thus sleep duration, short sleep (≤ 9 hours) and weekend oversleep (difference in sleep duration between weekday and weekend > 2 hours) were determined. Hong Kong children had later bedtime and wakeup time and slept consistently less than their Shanghai counterparts at both survey time points. The shorter sleep duration was particularly marked during weekdays. Over the interval period, weekday sleep duration significantly decreased from 9.2 to 8.9 hours as wakeup time became earlier for Hong Kong children, but increased from 9.4 to 9.6 hours as wakeup time became later for children in Shanghai. Children from both cities slept longer on the weekends. Prevalence of weekend oversleep significantly increased in Hong Kong children, but no interval change was found in Shanghai children. The findings indicate subcultural differences in sleep/wake patterns in Shanghai and Hong Kong school-aged children. In particular, sleep duration had increased for Shanghai children, but decreased for Hong Kong children over 10 years. The benefits and barriers of delaying school start time for optimizing sleep health in school-aged children should be further explored.