This perspective addresses an important gap in adaptive sport access for youth with limb loss (LL) and limb difference (LD). Although the potential benefits of sport participation are well documented, accessible adaptive sport opportunities remain limited. This article describes the development and implementation of a youth amputee soccer initiative on Long Island, New York. Guided by a biopsychosocial framework and supported by physical therapists, trained coaches, and adult amputee athlete mentors the program was designed to provide a structured and inclusive environment for skill development, peer interaction and enhanced community connection. Descriptive program data and caregiver reported feedback are presented to illustrate the perceived value of the program. Caregiver responses suggest high satisfaction, positive perceptions of social interaction, and appreciation for the mentorship and inclusive environment. These findings are preliminary yet suggest that intentionally designed, community based adaptive sport programs may contribute to expanding opportunity and supporting participation and belonging for youth with LL and LD.
Introduction There is a significant problem of unidentified and unaddressed reading disabilities leading to psychiatric problems in children and adolescents because of not having proper tools of assessments in schools. This research proposal can be a revolutionary paradigm in identifying, classifying, modeling, and benefitting children and adolescents with a specific learning disorder (SLD). Objectives The objective of the current research proposal is to provide a framework of our reading program and collect data over time as cohorts to reflect the positive outcomes of the reading program.Sub-Objectives 1. To provide an intervention that is accessible and feasible for children and their parents that will improve their academic and socio-emotional aspects.2. Educate parents regarding SLD.3. To provide reading training to address SLD in reading and improve reading.4. To provide Cognitive Behavioral Therapy (CBT) to target the anxiety and depression that results because of having a SLDin reading. Methods After a reading assessment, students with specific reading disabilities will be registered in the program for 10 weeks. Every student will have reading training and CBT on different days of the week via video conference. Data will be collected retrospectively from the initial cohort and subsequent cohorts will be added to the data collection process for a final analysis when 60 students have completed the program. Results Initial two weeks of reading training and CBT shows positive and promising results so far. Conclusions Children need to be screened at a young age for a reading disability before they struggle academically, and develop psychiatric issues later in life. Conflict of interest The aim of this research proposal is to help us understand, evaluate and benefit children with Specific Learning Disorder (SLD) with our newly setup reading program at RUSH University Medical Center, Department of Child and Adolescent Psychiatry.
Frailty is a condition commonly associated with aging, characterized by functional and cognitive decline, increasing dependence, and early mortality, but it is rarely conceptualized in children. We present a caregivers' perspective on frailty in her daughter living with childhood chronic kidney disease, highlighting the repercussions of chronic kidney disease and treatment on physical and psychosocial functioning across critical developmental years. The cumulative consequences of the deficits ultimately impaired long-term life participation and quality of life. However, frailty is increasingly recognized as a dynamic condition with the potential to be slowed down, arrested, or, in some instances, even reversed. There is, therefore, a need to better understand frailty in children, define tools that are developmentally appropriate, and ultimately routinize the measure and management of frailty within pediatric chronic kidney disease care. Children with chronic kidney disease deserve the opportunity to grow, flourish, participate in life, and enter adulthood with the best possible quality of life.
Abstract Background The COVID-19 pandemic created the most severe global education disruption in history. According to UNESCO, at the peak of the crisis over 1.6 billion learners in more than 190 countries were out of school. After one year, half of the world’s student population is still affected by full or partial school closures. Here we investigated whether or not it is possible to build a multivariate score for dynamic school decision-making specially in scenarios without population-scale RT-PCR tests. Methods Normality rate is based on a COVID-19 risk matrix (Table 1). Total score (TS) is obtained by summing the risk scores for COVID-19, considering the six parameters of the pandemic in a city. The COVID-19 Normality Rate (CNR) is obtained by linear interpolation in such a way that a total score of 30 points is equivalent to a 100% possibility of normality and, in a city with only six total points would have zero percent chance of returning to normality: CNR = (TS – 6)/24 (%). The criteria for opening and closing schools can be defined based on the percentages of return to normality (Table 2). Table 1. Limits for each parameter of the risk matrix and "normality" scores in relation to COVID-19: the lower the risk, higher is the “normality” score. Table 2. Criteria for opening and closing schools in a city according to the COVID-19 Normality Rate. Results at June 3rd, 2021, we evaluated all 5,570 Brazilian cities (Figure 1): 2,708 cities (49%) with COVID-19 normality rate less than 50% (full schools closure), 2,223 cities (40%) with normality rate between 50% and 70% (in-person learning only for 5 years and 8 months-old children), 583 with normality rate between 71% and 80% (in-person learning extended to children age 12 years and less), 583 cities (1%) with normality rate between 81% to 90% (in-person learning extended to the student population age 18 years), and just one city with 92% COVID-19 normality rate (in-person learning extended to all the student population). We calculated the COVID-19 normality rate between January and May, 2021, in four countries: Brazil, USA, UK, and Italy (Figure 2). At Jun, 3rd, 2021, percentage of people fully vaccinated in Brazil varied from 0% to 69%, an average of 11%. Figure 1. COVID-19 Normality Rate in 5,570 cities in Brazil, Jun/03/2021. Figure 2. COVID-19 Normality Rate between January and May, 2021: comparison among Brazil, USA, UK, and Italy. Conclusion COVID-19 vaccination programs take several months to implement. Besides fully vaccination of the population, it is important to check if people became really safe from the virus. The COVID-19 Normality Rate is a double check multivariate score that can be used as a criteria for optimal time to return to in-person learning safely. Disclosures All Authors: No reported disclosures
Aims Explore caregiver-reported value of developmental coordination disorder (DCD) diagnosis in children with multiple developmental concerns. Methods Participants were caregivers of 105 children aged 3-15 years (mean = 5.9, SD = 2.23) awaiting assessment at a tertiary diagnostic child development service who scored "suspect for" DCD on the Little-Developmental Coordination Disorder Questionnaire or DCD Questionnaire (DCDQ'07). Caregivers completed the Parental Perceptions of DCD Diagnosis Survey, developed for this study. Results Most caregivers (88.6%) reported a DCD diagnosis was moderately or very important. There were no clinically meaningful relationships between caregiver importance and number of developmental concerns (τb=0.194, p = 0.019), level of motor concern (DCDQ'07 τb=-0.002, p = 0.987; Little-DCDQ-CA τb=0.135, p = 0.278) or presence of co-existing diagnoses (r=-0.042, p = 0.671). The three most common factors contributing to caregivers' perceived value of diagnosis were: better understanding of their child, access to school services, and minimizing future impacts. The most common factors caregivers perceived as important for professionals were better understanding of their child, provision of medical or therapy services, and provision of participation support. Conclusion Caregivers of children with multiple developmental concerns valued a DCD diagnosis. For clinicians, this may inform decisions within the DCD diagnostic process of children with multiple developmental difficulties.
Abstract PURPOSE: Children treated for medulloblastoma (MB) undergo intensive multimodality treatment compromising surgery, irradiation, and chemotherapy, which is associated with a significant risk of neurocognitive deficits. Successive multicenter frontline treatment protocols have introduced reduced posterior fossa boost margins for cranial irradiation for sparing collateral tissue and preserving function. This study examines neurocognitive outcomes in the setting of reduced primary site target volume margins in children treated for MB. PATIENTS & METHODS: Prospective longitudinal neurocognitive data were collected from newly diagnosed patients with MB (n = 372, ages 3-21 years) enrolled on one of two sequential multicenter clinical protocols between 1996 and 2012. The treatment regimen included surgery, risk-adapted craniospinal irradiation with a posterior fossa boost with restricted clinical target volume (CTV) margins (2 cm and 1 cm), and dose-intensive chemotherapy. Comparative analysis of neurocognitive outcomes was performed using linear mixed-effects models. RESULTS: Intelligence quotient (IQ) scores were better preserved in average-risk patients who received treatment using a clinical target volume with a lesser margin of 1 cm (p < 0.0099). Findings were consistent with prior studies on measures of academics including reading performance, mathematical reasoning, and spelling across both risk groups regardless of CTV. CONCLUSION: This study presents compelling evidence in favor of restricted CTVs for preserving IQ without sacrificing treatment efficacy in average childhood MBs.
Abstract Child sexual abuse (CSA) remains one of Nigeria's most pervasive yet chronically underreported crises shaped by interlocking pressures of gender norms, cultural practice, and institutional weakness. This study examines how communication shapes discourse, perception, and disclosure of CSA among secondary school students in Abuja. Drawing on Foucauldian discourse theory, feminist frameworks, and participatory development communication, it uses a convergent mixed-methods design comprising surveys of 420 students, 12 focus group discussions, and 10 key informant interviews. The findings are revealing. Institutional communication is overwhelmingly top-down and monologic, leaving students without safe spaces for disclosure or meaningful participation. Silence surrounding CSA in these institutions is beyond a cultural artifact; it is structurally produced through power relations embedded in gender hierarchies, institutional inertia, and communicative systems that exclude children's voices. Girls face heightened vulnerability due to entrenched expectations of modesty and compliance, while boys encounter a different but equally powerful barrier, stigma anchored in hegemonic masculinity. Digital platforms have further expanded the terrain of CSA beyond physical school environments. Crucially, this study contributes something absent from most prior Nigerian research: the evidence that institutional failure under-trained teachers, absent reporting protocols, and underfunded counselling is as powerful a producer of silence as cultural taboo, and that children's silence is situational and changeable rather than fixed. The study recommends a transition from awareness-driven communication to dialogic, child-centred approaches, comprehensive sexuality education, and institutionally accountable reporting mechanisms.
Introduction Developmental studies in infancy remain rare. Studies measuring depressive symptoms in gifted children are contradictory, considering more anxiety or depression than in non-gifted children. Furthermore, questionnaires or anxiety scales are used without taking into account all aspects of mood disorders and thus, rarely depression scales have been conducted. Objectives To refine the developmental trajectory of depression in a national sample of French gifted children by identification of the specific risk and protective factors. Methods A self-reported depression scale MDI-C (Multiscore-Depression-Inventory-for-Children) were sent to families to be administered to their gifted children from preschool to high school, aged from 4 to 20 years-old (IQ >125) looking for help from gifted associations. A larger wave of data collection on different aspects of child and family history was collected (pregnancy, term and delivery mode, neonatal period, psychomotor development, health, schooling, interpersonal relationships with family and friends, personality, parental socio-economic status). Results 438 children (> 130) were eligible. Regarding anamnestic fields, Exploratory-Factor-Analysis highlighted six predictive factors of depression with eigenvalues from 1.09 to 3.17. Major factors explaining 62.96% of total variance are: Factor-1 “motor skills disorder” (14.53%). Factor-2 “positive family relationships” (14.04%). Factor-3 “positive social relationships with peers” (14.02%). Factor-4 “integration of social codes” (11.23%). Factor-6 “Learning disabilities and rehabilitation” (10.1%). Conclusions Our findings highlight specifics risk factors of depression in the field of learning disabilities or social cognition, while a good quality of social relationships since childhood seems to be a preventive factor. Disclosure No significant relationships.
Background Maternal and under-five mortality remain major public health concerns in many low- and middle-income countries, including Tanzania. Despite their widespread use in strengthening economic resilience, income-generating associations (IGAs) have not fully utilized their potential as platforms for addressing reproductive and child health (RCH) challenges. Objective This study aimed to co-design an intervention package with women participating in income-generating associations to enhance their preparedness and resilience in addressing RCH challenges in Tanzania. Methods A qualitative descriptive study guided by a Human-Centered Design (HCD) framework was conducted in the Arusha and Shinyanga regions of Tanzania. The study followed four iterative phases: (1) discovery and mapping of IGAs to understand members' experiences and RCH challenges; (2) co-design and prototyping of potential interventions with women and stakeholders; (3) validation of the prototype intervention package with additional IGA members; and (4) refinement of the package through consultations with reproductive and child health experts. Data was collected through focus group discussions, key informant interviews, and consultative workshops with individuals participating in IGAs, community development officers, IGA coordinators, and RCH stakeholders. Qualitative data were analyzed using thematic analysis, while intervention priorities were ranked based on acceptability, feasibility, and sustainability. Results The discovery phase revealed that IGAs function as important economic resilience mechanisms for women but are rarely utilized as platforms for reproductive and child health promotion. Key barriers included limited health education within groups, financial constraints affecting access to healthcare, gender norms influencing participation, and limited engagement among men. Through the co-design process, several candidate interventions were generated and prioritized. Four core components emerged as the most feasible and acceptable: (1) delivery of maternal and child health education through regular IGA meetings; (2) facilitation of health insurance awareness and enrollment among members; (3) strengthening governance and coordination within IGA groups; and (4) increasing participation and support for vulnerable women, including adolescent girls and young women. Validation with additional participants confirmed the feasibility and relevance of these interventions within the existing IGA structure. Conclusion The co-designed intervention package emphasizes the necessity of integrating health education, financial protection mechanisms, and governance strengthening within existing economic groups.
Abstract INTRODUCTION: Survivors of pediatric brain tumors experience significant cognitive deficits from their diagnosis and treatment. Mechanisms of cognitive injury are poorly understood, and predictors of long-term outcome are lacking. Large-scale, distributed brain systems provide a window into brain organization and function that may yield insight into these mechanisms and outcomes. Recent evidence suggests that systems-level changes are related to cognitive performance across the lifespan. Here, we evaluated brain network architecture, cognitive performance, and brain-behavior relationships in pediatric brain tumor patients. METHODS: Forty-nine patients (ages 7-18y.o.) with any brain tumor diagnosis underwent resting state functional Magnetic Resonance Imaging (rsfMRI) during regularly scheduled clinical visits. All patients were tested with the NIH Toolbox Cognition Battery. One-hundred thirty-nine age- and sex-matched typically developing children were used as controls. All data were processed to minimize artifactual sources of variance. Functional brain networks were created for each patient via rsfMRI data from 300 regions of interest that sample the whole brain. Multilinear models were implemented to examine brain-behavior relationships, while accounting for demographic and clinical factors. RESULTS: Functional network organization was significantly altered in patients compared to controls (p<0.001). Network organization was more affected in patients who received whole-brain radiation therapy than those who did not (t=2.52, p<0.015). Patients demonstrated significant impairments in multiple domains of cognitive performance, e.g. attention (p<0.0001). Weak relationships were found between cognitive performance and network organization, none of which survived multiple comparison correction. CONCLUSIONS: Brain network architecture is significantly altered in pediatric brain tumor patients. Whole-brain radiation was related to the largest changes. Most network and cognitive changes were significant with large effect sizes, yet brain-behavior relationships were weak. Our results suggest that systems-level changes in brain organization may provide insight into long-term changes in brain function in pediatric brain tumor patients.
