Every report we find, newest first.

Impact of mask-wearing on child and adolescent psychosocial development: a systematic review : Alice Freiberg

Abstract Background Wearing face masks in public is recommended under certain circumstances in order to prevent infectious diseases transmitted through droplets. The objective was to compile all German and English research results from peer-reviewed journal articles using a sensitive literature search on the effects of mask-wearing for preventing infectious diseases on the psychosocial development of children and adolescents. Methods A systematic review was conducted considering different study designs (search period up until 12 July 2021). The risk of bias in the studies was determined using a risk of bias procedure. A descriptive-narrative synthesis of the results was performed. A search update will be conducted shortly before the conference. Results Thirteen studies were included, and the overall risk of bias was estimated to be high in all primary studies. There are some indications from the included surveys that children, adolescents, and their teachers in (pre)schools perceived facial expression processing as impaired due to mask-wearing, which were confirmed by several experimental studies. Two studies reported psychological symptoms like anxiety and stress as well as concentration and learning problems due to wearing a mask during the COVID-19 pandemic. One survey study during the 2002/2003 SARS pandemic examined oral examination performance in English as a foreign language and showed no difference between the “mask” and “no mask” conditions. The results are preliminary and may be extended due to the search update. Conclusions Only little evidence can be derived on the effects of face masks on different developmental areas of children and adolescents based on the small number of studies. There is a lack of research data regarding the following outcomes: psychological development, language development, emotional development, social behaviour, school success, and participation. Further cluster-randomized controlled trials or longitudinal studies are required. Key messages • Empirical and experimental evidence shows that mask-wearing impairs facial expression among children, adolescents, and teachers in (pre)schools. • Research on the following developmental areas is missing: psychological development, language development, emotional development, social behaviour, school success, and participation.

Freiberg A, Horvath K, Hahne T et al.

O8-6 Participation in physical education, extra-curricular activities, and community sports among Irish adolescents with and without functional difficulties

Abstract Background Physical activity for adolescents with disabilities (AWD) are reported to have even greater health benefits than for adolescents without disabilities (AWoD). The settings for organised physical activity opportunities can include physical education, extra-curricular activities and community sport. Few studies have reported whether there are differences in participation in these settings between AWD and AWoD. The purpose of this study was to report differences in participation in organised physical activity between AWD and AWoD in Ireland. Methods Data, were disaggregated by disabilities, from the Irish children sport participation and physical activity 2018 study; a national representative self-report survey. Adolescents selected sports and physical activities they took part in the last 12 months in physical education, extra-curricular activities, and community sports. The child functioning module was completed with data coded according to the Washington group on disability statistics criteria. Data were stratified by gender and school level, with average scores of the number of activities analysed by T-Tests with Hedge's g, and no participation by Chi-square test of independence. Results The weighted sample included 6646 adolescents (53% female, 68% secondary level), of which 16% reported disabilities. Specific difficulties were sensory (4%), physical (1%), cognitive (7%), and behavioural (9%). More AWD reported they did not do any organised physical activities in all three settings (physical education, p = 0.029, extra-curriculum, p = >.001, community sport p = >.001) than AWoD. Adolescents with behavioural disabilities reported fewer types of physical education activities (males primary, p = .014, g =.31; secondary, p = .008, g = .24) and community sports (male primary, p = >.001, g = .49; female secondary, p = .027, g = .14) than adolescents without behavioural disabilities. Conclusions Adolescents with behavioural difficulties were the largest disability group and reported fewer number of organised physical activities than AWoD; reinforcing actions are needed to increase perceived choice of activities. An alarming number of AWD reported no organised physical activities in all three settings. More thorough studies are required to investigate these reasons, and to provide support across settings, whereby differences in participation between adolescents with and without disabilities are not so profound.

Ng K, Belton S, Murphy M et al.

157 Evaluating Interest in Clinical Trial Participation for the Treatment of Pediatric Food Allergy

OBJECTIVES/GOALS: Roughly 8% of children in the United States have a diagnosed food allergy (FA). The ubiquity of most food allergens increases the potential for accidental exposures. Clinical trials (CT) are used to test novel treatments for FA. This project will evaluate the influence of biopsychosocial factors on interest in CT participation for pediatric FA. METHODS/STUDY POPULATION: This project is subsumed under the FORWARD study (5R01AI130348-04), a multisite study currently underway at four pediatric FA clinics across the United States. Eligible participants include patients and families who meet the following criteria: 1) New clinic visit presenting for a possible FA complaint and/or has a physician diagnosis in a follow-up clinic visit; 2) child is between the age of 6-months and 12 years at intake visit; 3) are English speaking, and 4) no history of developmental disorders. Parents are asked to complete an intake survey, followed by a series of quarterly surveys administered via REDCap. A single variable from the intake survey queries interest in CT participation; quarterly surveys assess FA knowledge, attitudes, health beliefs, and management practices. RESULTS/ANTICIPATED RESULTS: To date, 890 families have completed the intake survey. Working hypotheses include: 1) parents of older children and children with a higher condition severity rating will report greater levels of interest in CT participation; 2) parents with greater FA knowledge, more health management beliefs that support action, and less FA-related anxiety, will report greater levels of interest in CT participation; 3) relative to White families, African American families will be less interested in participating; 4) families with >1 child with FA will report greater levels of interest in CT participation; 5) families who are uninsured, low-SES, and are unemployed will report lower levels of interest in CT participation; and 6) families with higher educational attainment will report lower levels of interest in CT participation. DISCUSSION/SIGNIFICANCE: This study will advance decision science, address existing disparities, and have far-reaching clinical implications. This novel approach will enhance our ability to predict who is at the greatest risk of anaphylaxis and help healthcare providers identify families who could benefit from experimental treatment options for pediatric FA.

Catlin P, Van Hecke A, Assa’ad A et al.

Sensory integration in a department of child and adolescent psychiatry

Introduction The area of Sensory Integration has its origin in the 1960s, developed by the neuroscientist and occupational therapist Jean Ayres. Although the first studies focused on the relationship between learning problems and atypical sensory processing, today there are new applications in clinical practice. Sensory integration is defined as the neurological process responsible for organizing the sensations that one receives from one’s own body and from the environment, in order to respond and function adequately in relation to environmental demands. Objectives This work has several objectives. On the one hand, review the concept of sensory integration, the definition and theoretical basis as well as the scientific evidence of this theory. On the other hand, review the use of sensory integration in psychiatric practice from the 1960s to the present day. Also, explain the experience of a child and adolescent psychiatry unit with the use of sensory integration as part of the treatment. Finally, new challenges, approaches and needs of psychiatry services will be considered for the implementation or improvement of this new work tool in a multidisciplinary team. Methods A bibliographic search has been carried out in the main sources of medical information such as pubmed, uptodate as well as in national and international journals. Likewise, the knowledge and clinical experience of the team has been reviewed. Results In our clinical experience, the child and adolescent psychiatry device for intensive outpatient treatment where patients between 12 and 17 years of age with severe mental disorders attend, initially passed the sensory profile by occupational therapy to patients who presented behavioral or emotional symptoms. not consistent with the psychopathological examination. In view of the results and magnificent progress, this intervention began to be carried out systematically to the boys who joined the device.We present the case of a 15-year-old patient who attended the device due to emotional dysregulation and suicidal risk. During evolution, possible difficulties were seen in sensory integration that made it difficult for the patient to improve with psychiatric or psychological therapy alone. The patient was evaluated and treated by the team’s occupational therapist, specifically trained in sensory integration. It was evaluated with the sensory profile, with the results having a sensory sensitivity profile and auditory and tactile avoidance. The specific measures that were carried out were: sensory diet and environmental modifications. Conclusions Sensory integration is a therapy with sufficient clinical evidence to implement it in child and adolescent psychiatry services. Therapy should be performed by suitably trained and validated occupational therapists. This therapy must be included in a multidisciplinary approach to the patient and specific modifications that can be developed at home and at school are provided. Disclosure of Interest None Declared

Maria Del Carmen M, Nadia B, Irene C

ACL Reconstruction for Open Physes Patient

Introduction: Participation of young athletes contributes to increment of ACL tears cases in children and adolescence. Management of ACL tears in that age group remains debatable. Traditionally, patients with immature bone have been treated without surgery or delayed reconstructive surgery to prevent iatrogenic growth retardation due to epiphyseal injury. However, conservative management showed poor results, the patient subsequently developed recurrent knee instability leading to progressive intraarticular damage, including secondary meniscus and chondral injuries. Special reconstruction technique is required to maintain the growth plate. The purpose of this study is to point out reconstruction technique available on managing ACL rupture. Method: This presentation review does systematic evidence based on literature review of management of ACL injury in skeletal immature patient. Results: There are some techniques that can be performed for paediatric patients are physeal sparing, with iliotibial band reconstruction, ACL reconstruction with all-epiphyseal tunnels and post distal fixation, all-epiphyseal tunnels reconstruction and fixation, partial transphyseal technique, and trans-physeal technique. The surgical technique was determined based on maturity and bone age using Tanner staging and hand radiographs. In pre pubertal patients, Tanner stage 1 or 2 (boys 12 years and girls 11 years) was performed using a physeal sparing. Young adolescents are still in their infancy, Tanner stage 3 or 4, boys 13-16 years old, it is better to have ACL reconstruction done with partial transphyseal or transphyseal technique. Older adolescents with physeal closure (males 15 years and girls 14 years) ACL reconstruction were performed as in adult patients. Discussion: The choice of reconstruction technique in pediatric patients is based on the maturity and bone age of the child. In the pre-pubertal period with Tanner stage 1 or 2 experiments can be carried out non-operative measures followed by physeal sparing reconstruction, young adolescents are still in their infancy, transphyseal reconstruction is carried out, reconstruction in older adolescents is carried out as in adults. Some consideration makes decision whether not to operate or operate the patient. Concerns regarding injury to physic, leg length discrepancy, and source of graft led the innovation of the surgical technique to reconstruct the ACL.

183 Explaining Research to Children and Adolescents

OBJECTIVES/GOALS: By establishing a youth-centric web-app as a central hub of information and inspiration in an attempt to engage a young demographic, this project aims to increase community awareness and reduce misconceptions surrounding clinical trials, in hopes of fairly representing marginalized communities among future clinical trial participants. METHODS/STUDY POPULATION: We designed a children’s web-app to host a collection of child-friendly educational materials (such as picture books, games, and age-appropriate articles about advances in clinical research) explaining clinical research and its process. An emphasis was put on ensuring the web-app and its contents were understandable and appealing to children. The effectiveness of this tool will be tested through a focus group study. Children ages 7-10 will be given a preliminary survey measuring their knowledge and opinions about clinical research, and then given time to explore the web-app. Afterwards, they will be given a secondary survey to gauge their acquired knowledge from the website and asked about their opinion on the design and usability of the web-app and its materials, as well as how likely they were to revisit the site. RESULTS/ANTICIPATED RESULTS: We anticipate a very positive response from the children regarding the design and usability of the web-app and its materials. By using an adolescent-focused design methodology at every step of the design process, we will ensure that all materials are attractive and engaging to our younger target audience. Exposing children to accessible information about clinical trials at a young age allows us to build their trust in the research process prior to the possible internalization and acceptance of cultural misconceptions. Over time, we hope to see a change in attitudes toward clinical research as well as increased participation, whether from under-represented groups or a younger demographic, and positively contribute to T3 and onwards in the translational continuum. DISCUSSION/SIGNIFICANCE: In a rapidly changing world, the best approach to making change is through targeting the younger demographic, the leaders of tomorrow. Our project will allow adolescents to foster a more well-rounded opinion of clinical research, increasing their participation and better paving a more positively received future for translational science as a whole.

Johnson T, Black S, Smith B et al.

SOCIAL PARTICIPATION AND DEPRESSIVE SYMPTOMS AMONG SPOUSAL AND ADULT CHILD CAREGIVERS

Abstract Participating in social activities through formal (e.g., social or religious organizations) and informal (e.g., gatherings with family members or friends) avenues is known to positively contribute to mental wellbeing. Family caregivers are at risk for limited social participation and increased depressive symptoms. However, little is known about which social activities are associated with depressive symptoms among spousal and adult child caregivers. The purpose of this study was to examine the effects of participating in various social activities on depressive symptoms among spousal (n=422) and adult child (n=1,112) caregivers using data from the 2017 wave of the National Study of Caregiving. Caregivers reported on participating in six social activities in the past month (e.g., visiting family and friends, attending religious services, doing volunteer work, working for pay) and completed the 2-item Patient Health Questionnaire to assess depressive symptoms. Data were analyzed using multiple linear regression, with separated models for spousal and adult child caregivers. Sociodemographic characteristics, self-rated health, and dementia caregiving status were included as covariates. For spousal caregivers, visiting friends or family and attending religious services were associated with lower depressive symptoms (b=-.55, p=.010 and b=-.33, p=.036, respectively). For adult child caregivers, going out for enjoyment was associated with lower depressive symptoms (b=-.80, p<.001). Findings suggest that spousal and adult child caregivers may benefit from participating in different types of social activities. Interventions targeting social participation to reduce depressive symptoms need to be tailored to the needs and preferences of spousal and adult child caregivers to be most effective.

Psychological Issues among Adult Patients with Untreated Clef Lip and Palate: Algerian Survey-based study

Introduction Cleft lip and palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. Individuals with a cleft of the lip and/or palate (CL/P) differ from their peers due to their facial appearance, hearing and speech problems, in addition, it causes psychosocial impacts among affected children. However, among untreated adults, it seems that psychological sequelae can be major and life limiting. Objectives The purpose of this study is to assess Algerian untreated young CL/P patients psychological and lifestyle issues. Methods This is a survey-based cross-sectional study conducted during August- October 2022 in Algeria through an online survey which is a self-administered questionnaire ( SAQ). The study target population were young individuals ( age between 17 and 30) with untreated or partially treated clef lip and palate confitions. The questionnaire consisted of 10 multiple questions including a demographic section, evaluating patients satisfaction, lifestyle, psychological problems related to their conditions and limitations due to it. All participants provided their informed consent prior to their participation. The Statistical Package for the Social Sciences (SPSS) version 22.0 was used to analyse the collected data. Results Final sample size consisted in 207 responses. The mean age of the participants was 24.3± 3 years. Findings showed that slightly more that three fourths (75,9%) of participants reported that they are unsatisfied of their life because of their CL/P condition. Among 120 uneducated participants, (67%) of them reported thay they abandoned school because of their appearance. For P <0.001, suicide thoughts were higher among female participants (38%) than male participants (9%). Almost half of respondents (49.4%) presented strong immigration desires due to their education, relationships and psychosocial health issues. Conclusions The psychological impact of cleft lip and palate in adults appears to be disturbing, chronic and life-limiting. Urgent approaches to ensure the early management of cleft lip and palate in Algeria remain mandatory. Increasing the number of specialized maxillofacial services seems to be a good first step. Disclosure of Interest None Declared

Rais M, Moussa A

Envisioning supportive and safe learning environments: A dialogical study with LGBTQ+ adolescents living with chronic conditions or diagnoses : Lourdes Cantarero Arevalo

Abstract Background LGBTQ+ adolescents living with mental conditions are affected by stigma based on their health status, sexual orientation, and/or gender identity/expression (SOGIE), especially when navigating their learning environments. Our aim is to gain detailed insights into how LGBTQ+ adolescents living with mental conditions vision their learning environments so that they can feel safe and supported enough to freely disclose their SOGIE and health status, and hence thrive. Methods Aware of the participants’ vulnerabilities, a dialogical narrative-based approach was used to gather thick descriptions and deep insight, while applying the “seven C's”: conversation, curiosity, context, complexity, challenge, caution, and care (Frank, 2019). Recruitment was done through LGBTQ+ Denmark and via networks of networks. Two LGBTQ+ young adults living with chronic conditions held the dialogues. Mode of communication was chosen by the participants (either face-to-face, via internet or via telephone). Data analysis was conducted via the “analysis grid” (Roest et al. 2021). Results Nine dialogues lasting from 20 to 50 minutes were held with youth from 14 to 24 years old during spring 2022. According to their narratives, supportive and safe learning environments would: respect for change of names and pronouns, update learning materials, allow for flipped classrooms (hybrid teaching tested under COVID lockdowns), have separate neutral change rooms/bathrooms and create safe private spaces to take medications. They would also permit higher absenteeism rates for those living with chronic conditions or getting hormonal treatments, allow for more breaks/slower version of the pensum, and show proactive healthy curiosity and respect for “invisible diseases”, fluid SOGIEs and neurodiversity/neurodivergent profiles. Conclusions The differing participants’ narratives provide innovative ways to create safe and supportive inclusive learning environment that embrace and enhance diversity.

Cantarero Arevalo L, Skov Nielsen A, Slyngbord L