Taiwanese Preschool Children Research Articles

Exploring Taiwanese preschool children’s perspectives on the value of caring

ABSTRACTThe current study explores Taiwanese preschool children’s understanding of the value of caring in school. This study offers researchers and practitioners opportunities to study children’s perspectives in a particular cultural setting and discuss the connectedness of culture and children’s views on caring. Participatory research and qualitative methods were used, encompassing the collecting of children’s speech, photography, and drawings. The findings regarding the understanding of caring indicated the following: (1) Children interpret caring among peers and from school surroundings; (2) children perceive teacher care in daily classroom routines; (3) children learn about values when outdoors, in learning areas, and during transition times; and (4) children exhibit the ability to distinguish non-caring behaviour. This study shows that for children caring was most frequently defined as helping others in need and as teacher care in daily routines. The children’s views on caring were influenced by culture, and they created meanings for caring.

The relationship between oral language and storytelling prosody in preschool children

The study examined storytelling prosody (i.e., prosodic variations in retelling a story) and the relation with oral language in Taiwanese preschool children. One hundred and twenty-eight preschool children aged 4 and 5 were recruited and given the following tasks: nonverbal intelligence, vocabulary, syntax, and storytelling prosody. Children's storytelling prosody was evaluated by a four-point scale (i.e., expression-and-volume, phrasing, smoothness and pace). Results revealed that (i) storytelling prosody differed as a function of oral language, (ii) different dimensions of storytelling prosody (e.g., expression-and-volume and phrasing) were correlated with syntactic and vocabulary knowledge and (iii) language production predicted storytelling prosody in male children, but not female children. Together, oral language is correlated with storytelling prosody among preschool children, especially male children. Highlights This study examined the relationship between oral language and storytelling prosody. 128 preschool children's storytelling prosody was evaluated via a rating scale. Storytelling prosody differed as a function of oral language and was correlated with vocabulary and syntactic knowledge. Oral language only predicted storytelling prosody in male children, but not female children. Results highlighted the relationship between oral language and storytelling prosody, which is an early predictor of reading comprehension.

Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children.

Parent and teacher ratings of child behaviors are often discrepant, and these discrepancies may be correlated with parenting stress. The present study explored whether various parenting stress factors are associated with discrepancies between parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) as well as internalizing symptoms in preschool children. We recruited 299 Taiwanese preschool children (aged 4–6 years) from the community or via clinical referrals. A structural equation modeling was used to analyze the relationships among three factors derived from the Parenting Stress Index-Short Form and informant discrepancies on symptoms of inattention, hyperactivity/impulsivity, ODD, and internalizing behaviors. Scores reported by parents were higher for each of the symptoms examined than those reported by teachers, and the degree of agreement between informants ranged from low to moderate. The parental distress factor of parenting stress was associated only with parent ratings, whereas other factors of parenting stress—parent-child dysfunctional interaction and parents’ stress resulted from their child’s temperament—were correlated with both parent and teacher ratings. Only parental distress factor predicted informant discrepancies for all behavioral symptoms assessed. Our findings suggest that parental distress should be considered when parent rating scores show significant discrepancies from that of teacher rating scores.

The utilization of fluoride varnish and its determining factors among Taiwanese preschool children

BackgroundThe Taiwanese government considers fluoride varnish to be a major component of preventive dental cares for preschool children. This study aimed to explore the extent of utilization of fluoride varnish and its determining factors among Taiwanese preschool children. MethodsUsing preschool children under the age of 5 years as our participants, this study was conducted based on the 2008 Taiwan database of the Ministry of the Interior, linked with information gathered between 2006 and 2008 on preventive healthcare and health insurance from the Bureau of Health Promotion and the National Health Research Institute. A total of 949,023 preschool children (< 5 years old) were identified to meet the requirement for fluoride varnish services. ResultsThe percentage of Taiwanese preschool children that used fluoride varnish was 34.85%.The probability that fluoride varnish would be utilized was higher among children with catastrophic illness/injury or relevant chronic illnesses than those without. In addition, the probability of children with disabilities using fluoride varnish was lower than that of nondisabled children. Finally, parent sex, parent age, urbanization level of residence, and parents' premium-based salary significantly affected the children's utilization probability of fluoride varnish. ConclusionIn order to increase the utilization of fluoride varnish among preschool children in Taiwan in the future, target groups consisting of females, children < 3 years of age, and disabled children should be prioritized. Parental factors are also important in affecting the utilization of fluoride varnish in children.

Association between the First Occurrence of Allergic Rhinitis in Preschool Children and Air Pollution in Taiwan.

The occurrence of allergic rhinitis (AR) may be significantly influenced by air pollution. This study examined the association between the first occurrence of AR in preschool children and the pre-incident levels of air pollutants in Taiwan. We identified 9960 eligible subjects from a systematic sampling cohort database containing 400,000 insureds of the National Health Insurance from 2007 to 2011 and matched them with the environmental monitoring data from 2006 to 2011 according to the locations of their clinics. Pre-incident levels were determined using the average concentrations of air pollutants one or two weeks prior to the AR diagnoses. Logistic regression analyses were performed to determine any significant relationships between AR and specific air pollutants. The first AR incidence for Taiwanese preschool children, which increased with age, was 10.9% on average; boys appeared to have a higher percentage (14.2%) than girls (8.27%). Among the air pollutants, carbon monoxide (CO) and nitrogen oxides (NOX) were significantly related to AR after adjusting for age and gender (p < 0.05). Because both pollutants are considered to be traffic emissions, this study suggests that traffic emissions in Taiwan need to be controlled to lower the prevalence of children’s AR.

Relationship between Sleep Habits and Daytime Sleepiness, Inattention, and Aggressive Behavior among Taiwanese Kindergarten Children

Objectives: Sleep is a physiological process essential to life. The aim of this study is to investigate the association between demographic factors, sleep habits, and behavior in Taiwanese preschool children. Methods: This is a cross-sectional study conducted between February 2012 to April 2012. Children aged 3 to 6 years (mean age=4.59 years; 50.83% girls) were recruited from certified public or private preschools in Taiwan. Using stratified random sampling, we distributed 1,750 copies of a self-designed questionnaire and collected 1,204 effective samples. Primary caregivers completed the questionnaire by providing information about the sleep habits and behavior of their children. Results: The preschool children’s behavior, ranked from high to low frequency, were inattention (close to the “sometimes to usually” category), daytime sleepiness (close to the “sometimes” category), and aggressive behavior (close to the “never” category). Preschool children who were 6 years old (F=15.98, p<0.001) and girl (t=-3.87, p<0.01) had longer attention spans than 3 or 4 year olds and boy, respectively. There were no significant differences between ages and sex for daytime sleepiness and aggressive behavior. Multiple regression analysis revealed that the preschool children with less daytime sleepiness, longer attention spans, and less aggressive behavior were those who had slept more than 10.01 hours at night, went to bed before 9:00 p.m, watched television less than one hour per day on weekdays, and caregiver’s education ≥ college. Conclusion: Favorable sleep habits are crucial for preventing daytime sleepiness, inattention, and aggressive behavior in preschool children.

Reference Value of Impulse Oscillometry in Taiwanese Preschool Children

Impulse oscillometry is a potential technique for assessing the respiratory mechanism-which includes airway resistance and reactance during tidal breathing-in minimally cooperative young children. The reference values available in Asian preschool children are limited, especially in children of Chinese ethnicity. This study aimed to develop reference equations for lung function measurements using impulse oscillometry in Taiwanese children for future clinical application and research exploitation. Impulse oscillometry was performed in 150 healthy Taiwanese children (aged 2-6 years) to measure airway resistance and reactance at various frequencies. We used regression analysis to generate predictive equations separately by age, body height, body weight, and gender. The stepwise regression model revealed that body height was the most significant determinant of airway resistance and reactance in preschool young children. With the growth in height, a decrease in airway resistance and a paradoxical increase in reactance occurred at different frequencies. The regression curve of resistance at 5Hz was comparable to previous reference values. This study provided reference values for several variables of the impulse oscillometry measurements in healthy Taiwanese children aged 2-6 years. With these reference data, clinical application of impulse oscillometry would be expedient in diagnosing respiratory diseases in preschool children.

Uncorrected Visual Acuity and Noncycloplegic Autorefraction Predict Significant Refractive Errors in Taiwanese Preschool Children

To investigate the accuracy of uncorrected visual acuity (UCVA), stereopsis, and noncycloplegic autorefraction (NCAR) tests performed by vision-screening technicians and to determine the best referral criteria when using these methods to screen for significant refractive errors in preschool children. Retrospective, case-control, and cross-sectional study. We reviewed 1000 records for a population-based preschool vision-screening program. The target conditions were defined as myopia ≤-3.0 diopters (D), hyperopia ≥ 4.5 D, astigmatism ≥ 2.0 D, and anisometropia ≥ 2.0 D. Receiver operating characteristic (ROC) curve was used to calculate optimal referral cutoff values. The examination results obtained by the vision-screening technicians were compared with those obtained by a pediatric ophthalmologist, which were considered the gold standard. The efficacies (sensitivity, specificity, positive predictive value, and negative predictive value) of different tests were evaluated. In 7.0% (95% confidence interval [CI], 5.3-8.7) of the children, at least 1 eye showed 1 of the target conditions. If only the right eyes were considered, the prevalence of target conditions was 4.2% (95% CI, 2.9-5.5). The ROC curve analysis indicated that the NCAR cylinder test (cutoff value ≥ 0.875 D) was the best test for screening target conditions. With regard to age groups, UCVA ≤ 0.75 (Snellen equivalent) and ≤ 0.85 were the best referral criteria for ages ≤ 4 years and ≥ 5 years, respectively. Combining the UCVA test with the NCAR test (the child was referred after failing both tests) increased specificity without significantly decreasing sensitivity. The UCVA and NCAR tests performed by vision-screening technicians are adequately sensitive and specific for preschool vision screening. The ROC curve analysis was used for determining the appropriate screening criteria for these tests, and combining the tests increased their accuracy. The screening criteria should be age dependent. When analyzing the test accuracy in ophthalmic problems, if the disease of interest does not symmetrically (in terms of disease severity and prevalence) involve both eyes, the prevalence based on only 1 eye should be interpreted with caution.

Patterns of sensitization to peanut allergen components in Taiwanese Preschool children

Peanut allergy is very common in Western countries, although it is seldom encountered in Eastern countries. Peanuts are comprised of at least 11 components, but the contribution to clinical symptoms by each component in each individual is not known. This study investigated the distributions of sensitivity to peanut allergen components among Taiwanese children who were sensitized to peanuts and followed the evolution of sensitization patterns to these components. We enrolled 29 preschool children (age=2.11±1.36 years) who were sensitized to peanuts above class 3. Serum was analyzed for specific immunoglobulin E (IgE) antibodies to recombinant Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9. Allergen component-specific IgE ≥0.35 kU(A)/L was defined as positive. Eighteen children were retested 22.64±5.1 months later. Peanut allergy symptoms were recorded from detailed questionnaires. The percentages of children sensitized to Ara h 1, 2, 3, 8, and 9 were, respectively, 51.8%, 65.5%, 62.1%, 13.8%, and 24.1%. Regarding changing patterns of peanut component sensitization at follow-up, children with clinical symptoms to peanuts had persistent elevations of Ara h 2-specific IgE: 12.6±1.01 up to 34.15±19.4 kU(A)/L; p=0.144. In contrast, Ara h 2 concentrations decreased significantly in children without clinical symptoms. Ara h 8 and 9 were nonspecific for children with or without symptoms. Ara h 1, Ara h 2, and Ara h 3 were major components contributing to peanut sensitization in Taiwanese children. Ara h 2 was probably the most important component that contributed to clinical symptoms and remained steady in children who had peanut allergy.

"What do you want to do when you grow up?" Occupational aspirations of Taiwanese preschool children

Occupational aspirations have mainly been investigated with teenagers, high school students, and adults. Following Gottfredson's (1981, 2002) theory of circumscription and compromise, in which it is proposed that occupational aspirations originate in the preschool years, in this study the occupational aspirations of 1,044 preschool children in Taiwan were explored. Children who attended 38 kindergartens and were between the ages of 5 and 6, expressed their preferences about and gender orientations towards occupations and careers. In general, the occupations Taiwanese children said they most desired to pursue were teaching, being police officers, and working as doctors. Most children can recognize the occupations of their parents at this stage, and the results in this research show that children still identify strongly with their parents' stereotypical occupations. More boys than girls showed a preference for masculine-dominated occupations. More girls than boys showed a preference for nontraditional occupations. Factors that influence occupational aspirations were found to be parental identification and identifying with the role of teachers.

Maternal-reported behavioral and emotional problems in Taiwanese preschool children

There has been limited epidemiologic information concerning preschoolers' behavioral and emotional problems in Eastern societies. This study was therefore aimed to investigate behavioral and emotional problems in a large sample of Taiwanese preschoolers using the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). The CBCL/1.5-5 was scored by mothers of 645 Taiwanese preschoolers aged 24-71 months. Psychometric features of the scale as well as the raw scores and prevalence rates of behavioral problems of Taiwanese preschoolers were compared with those of American counterparts. Several demographic variables with the Total Problems and syndromes scores were also examined. The CBCL/1.5-5 was found to have good to excellent levels of reliability (internal consistency, test-retest reliability and inter-parent agreement) and an acceptable model fit of seven-syndrome factor structure (root mean square error of approximation=0.055) when used with Taiwanese preschoolers. The prevalence rate of Total Problems, Internalizing syndrome and Externalizing syndrome score in the clinical range was 25.1%, 11.2% and 25.4%, respectively. Cross-cultural comparisons showed that Taiwanese preschoolers had higher scores in six narrow-band syndromes (effect size d=0.17-0.43, all p's<0.005) and prevalence rates of four Internalizing-related syndromes and Sleep Problems than American sample (odds ratio=2.4-4.9, all p's<0.005). Analyses of behavioral correlates revealed associations of first birth order with higher Internalizing, Externalizing and Total Problems scores (all p's<0.05). Furthermore, younger ages (24-47 months) and male gender were associated with higher Externalizing and Total Problems scores (all p's<0.05). Our data have provided important epidemiologic information to assist in clinical assessment and management of preschoolers' behavioral and emotional problems in an Eastern society.

Role of assessment tests in the stability of intelligence scoring of pre-school children with uneven/delayed cognitive profile

As part of an ongoing clinical service programme for pre-school children with developmental delay in an Asian developing country, we analysed the effect of three assessment tests, that is, Bayley Scale of Infant Development-II, Leiter International Performance Scale - Revised and Wechsler Preschool and Primary Scale of Intelligence - Revised - Chinese, on the stability of intelligence quotient (IQ) of children from pre-school through early childhood. The participants were 313 Taiwanese pre-school children with uneven or delayed cognitive profile and they were followed through early childhood. IQ stability was explored by different tests and among children of different clinical diagnosis: 168 children with non-autistic intellectual disability, 73 children with autism spectrum disorder, 58 children with mixed receptive-expressive language disorder and 14 children of other heterogeneous diagnoses. Stability of scores was evaluated using the r-squared for Pearson's coefficients to see the correlation between initial IQ (IQ1) and follow-up IQ (IQ2). Multiple linear regressions were also applied to see whether IQ1 had predictive ability for IQ2 and test-test difference in the total 313 children and each diagnostic subgroup. Results revealed that mean IQ1 was 65.8 ± 15.4 while mean IQ2 was 73.2 ± 17.9 for the total 313 children. The IQs were stable across an average follow-up duration of 38.6 ± 22.1 month from pre-school into early childhood. Patterns of positive correlations between IQ1 and IQ2 were noted by all the tests (r-squared = 0.43-0.5, all P < 0.001) and in the majority of diagnostic subgroups. Multiple regressions analysis also revealed that IQ1 could predict IQ2 significantly in all the tests (all P < 0.001). After careful choice of appropriate initial test, stability of IQ in children with developmental delay was noted from pre-school through early childhood. In addition, the translated version of cognitive assessment was valid for the required context of an Asian developing country. With the current emphasis on early identification and intervention for pre-school children with developmental delay, this information bears merit in clinical practice.

Visiting Doctors' Offices: A Comparison of Korean and Taiwanese Preschool Children's Narrative Development

Research Findings: This study aimed to explain age and cultural differences in the narrative development of 3-, 4-, and 5-year-old Korean and Taiwanese children. The participants comprised 140 children of middle-class, two-parent families, half from each cultural group. Children were individually interviewed about their experience of visiting doctors' offices. The measured variables were the total number of clauses, the total number of conjunctions, the total number of internal state terms, and the developmental level of the narrative structure. The results suggested that age was related to all 4 variables. Different narrative skills exhibited different developmental trajectories in the early phase of narrative development. Also, Taiwanese children were more likely to incorporate internal state terms into their narratives than were Korean children. Finally, there appeared to be a developmental leap in Korean 5-year-olds' performance of narrative structures. Compared with Taiwanese children, the development of narrative structures for Korean 5-year-olds was more advanced. Practice or Policy: Results are discussed in relation to the effects of local educational and childrearing practices. Implications for school readiness and theories are included.

Astigmatism in preschool children in Taiwan

To elucidate the prevalence of astigmatism and its corneal component, the association between the amount of astigmatism and its axis, and the association between the axis of astigmatism and body mass index (BMI) in Taiwanese preschool children. In this population-based study we analyzed 2 data sets, one obtained by retrospective review of vision-screening data and another obtained in a prospective observational study. Each study collected data for age, sex, and refraction status. Autokeratometry, height, and weight measurements were obtained only in the observational study. Astigmatism was classified as with-the-rule, against-the-rule, or oblique. The prevalence of astigmatism was unassociated with age or sex in both data sets. The retrospective study (1,094 subjects; mean age, 5 years; range, 2.19-7.32 years) revealed that 13.3% of the subjects had astigmatism > or = 1.00 D, and most of them had with-the-rule astigmatism; 4.0% had high astigmatism (>1.50 D). Children with with-the-rule astigmatism had greater mean cylinder power than those with against-the-rule or oblique astigmatism. In the prospective study (190 subjects; mean age, 5.65 years; range, 3.79-6.68 years) astigmatism correlated with its corneal component. Preschoolers with with-the-rule astigmatism and with-the-rule corneal astigmatism had greater BMI and heavier weight than those with against-the-rule or oblique type. Astigmatism is common in Taiwanese preschool children. The predominant types are with-the-rule and oblique astigmatism. Most patients with high astigmatism and high corneal astigmatism have with-the-rule type. High BMI or weight is associated with with-the-rule astigmatism and with with-the-rule corneal astigmatism.

Elements in the Sera of Preschool Children Living in Central Taiwan

AbstractThis study assessed elemental concentrations in the serum of 154 preschool children in central Taiwan via instrumental neutron activation analysis (INAA). A total of eight elements, Br, Cl, Fe, Na, Rb, Sc, Se and Zn of sera for Taiwanese preschool children living at four residential areas:Taichung city, Taichung urban townships and in a remote area inhabited by two groups of aborigines, Atayal and Bunun were determined. Standard reference materials (tomato leaves, NIST‐SRM 1570a, and lichen, IAEA‐336) were used as quality control standards to crosscheck the accuracy. Residential area, socioeconomic status and gender were shown to significantly influence serum levels of the eight trace elements. Statistical analysis revealed several different gender patterns via the two‐tailed student's test. A quantified index of agreement (AT) was used to classify these elements. Small AT indicated a close consistency, while large AT indicated a larger fluctuation, or less agreement, such that the correlation between the elements could be interpreted using a series of quantified indices at the serum levels of preschool children.

Development and psychometric properties of the Chinese language version of the TAPQOL: a health-related quality of life instrument for preschool children

The objectives of this study were to assess psychometric properties of the Mandarin version of the TZO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire in Taiwanese preschool children. Two groups of children, a very low birthweight group (n=118) and a not-very low birthweight group (n=170), were recruited. The internal consistency was acceptable and the correlation coefficients between the 12 subscales were low. Confirmatory factor analysis supported the 12-factor structure. Children with very low birthweight had significantly lower quality of life scores. This instrument may be used in clinical and research applications to investigate quality of life among preschool children.

Preschool children with autism spectrum disorders in Taiwan: follow-up of cognitive assessment to early school age

In this study, we longitudinally followed into childhood a cohort of preschool children, initially diagnosed as autistic or non-autistic with developmental delay, to evaluate the stability of cognitive assessments performed during the preschool period. The consistency in group means and intra-individual stability of developmental quotients (DQ) and non-verbal intelligence quotients (IQs) were compared for these two groups, which were matched by chronological age, initial non-verbal IQ/DQs, initial test given, and length of follow-up interval. The case group comprised 16 autistic children with average age at initial assessment of 3 years 8 months. The control group comprised 16 non-autistic developmental delayed children with average age at initial assessment of 3 years 11 months. Mean DQ/non-verbal IQ at initial assessment was 73.9±23.9 for the case group and 80.3±23.2 for the control group. ANOVA yielded no significant effect of time or time×diagnosis interaction ( F=0.183, P=0.675). The absolute difference in scores and group means were equivalent for both groups of children, with no difference in patterns of change. Correlations between DQ/non-verbal IQs at initial assessment and follow-up were significant and high for the two groups (autistic group: r=0.87; control: r=0.77). Intellectual functioning can be a valid measure in Taiwanese preschool children with autism, and has an equivalent meaning for children with autism and for non-autistic children with developmental delay. Though the follow-up period is too short for definite prognostic conclusions to be drawn, we think that non-verbal intelligence should be an essential assessment for preschool oriental autistic children so that sound expectation and treatment plan can be made.

Across Time and Beyond Skin: Self and Transgression in the Everyday Socialization of Shame among Taiwanese Preschool Children

This study examines the construction of the culture‐specific self through a form of seemingly harmful socializing practices among young Taiwanese children. Spontaneous daily family interactions have been systematically and longitudinally videotaped in seven families and events of shame are found to occur regularly at all datapoints. One third of these events occur in chains, involving multiple episodes about the child’s transgressions committed at different times, mostly in the here‐and‐now, followed by reenactments of the past and expectations for a better self in the future. While in nearly half of the episodes, some authority is explicitly invoked to judge the child’s behaviors, family members are always co‐present with the child and ready to share his/her transgression and shame. Findings of analyses on spatiotemporal and relational markers in these situated events suggest a dynamic and fluid view of the self and a holistic treatment of multi‐leveled contexts.