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21,850 reports · page 782 of 2185
This series of films helps those working and volunteering with children and young people to explore what online safety means, recognise the risks children face and understand how to support children’s safety online.
This series of expert insight films helps those working and volunteering with children and young people to understand what child criminal exploitation is, recognise the signs and respond effectively.
Students who frequently miss school are at greater risk for academic difficulty. High levels of absenteeism as early as kindergarten have been associated with long-term consequences, such as low reading proficiency in Grade 3 and low academic achievement in Grade 5, both of which have been associated with lower rates of high school graduation and enrollment in post-secondary education. The prevalence of school absenteeism has increased significantly since the COVID-19 pandemic and there have been sustained shifts in student attendance rates from kindergarten to Grade 12 since 2020. The goals of this population-level, repeated cross-sectional cohort study were to compare rates of chronic absenteeism, defined as being absent from school at least 10% of the time, in kindergarten in Canada before and after the onset of the COVID-19 pandemic, and examine the association between children's chronic absenteeism and their concurrent developmental vulnerability. A total of 513,159 kindergarten children participated in the study, with 284,712 (55.5%) being in the pre-COVID-19 cohort (2017-2020) and 228,447 (44.5%) in the post-COVID-19 cohort (2020-2023). Across Canada, rates of chronic absenteeism increased from pre- to post-COVID-19, from 17.7% to 41.3%, with differences by jurisdiction. The greatest increase was seen in Ontario, while the smallest increase was seen in British Columbia. Children attending kindergarten in the post-COVID-19 cohort were three times more likely to be chronically absent compared to their peers attending kindergarten before the onset of the pandemic. Despite this, chronic absenteeism in the post-COVID-19 period was associated with reduced odds of overall developmental vulnerability, a pattern that is likely attributable to shifts in the composition of chronically absent children. In the post-COVID-19 cohort, a greater percentage of children who were chronically absent resided in higher SES neighbourhoods compared to their chronically absent peers attending school before the onset of the pandemic. While increasing rates of school absenteeism should not be ignored, our results suggest that chronic absenteeism following COVID-19 might be more nuanced than before. The jurisdictional differences in rates of chronic absenteeism observed in this study could be due to the various public health measures put in place by the various provincial and territorial governments. It is also possible that the children from higher SES neighbourhoods missed more school after the onset of the COVID-19 pandemic because their parents had the capability to work from home, making it easier to keep their child(ren) home from school. The decreased association between chronic absenteeism and developmental vulnerability post-COVID-19 may be partially related to changes in access to online learning resources, which could have enabled some students to remain academically engaged while at home. However, further research is needed to better understand the underlying reasons for school absence and how the relation between absenteeism and academic achievement may vary across developmental stages to effectively support learning trajectories.
Reid-Westoby C, Duku E, Gaskin A et al.
Background An estimated 1 in 4 children seeking mental health care have an undiagnosed fetal alcohol spectrum disorder (FASD). Few mental health providers receive training or feel competent to serve this population. Evidence-based interventions (EBIs) for FASD have low uptake across mental health settings. Objective This study aimed to systematically adapt an EBI to increase access to care for youth with FASD in mental healthcare settings, resulting in the innovative Families Moving Forward (FMF) Connect Pro program. Method A multidisciplinary planning group employed the theoretically-driven implementation science framework, Intervention Mapping-Adapt (IM-Adapt). This 6-step process incorporated multiple information sources, including literature review, theory, clinical wisdom, and focus groups. 18 community mental health providers participated in focus groups to assess the fit of the adapted program. Data were analyzed with rapid qualitative methods using the COM-B model (Capability, Opportunity, Motivation) of behavior change and Theoretical Domains Framework (TDF) for coding and interpretation. Results Step 1: Planning group developed a logic model of change. Step 2: Review of EBIs, selecting the Families Moving Forward (FMF) intervention and two training methods: Extension of Community Healthcare Outcomes (ECHO) and Self-Directed modular approaches. Steps 3&4: Planning group identified needed adaptations for providers with low utilization of FASD-informed care and flexible use in diverse settings. Focus group participants reviewed prototypes of the resulting FMF Connect Pro program, endorsing high acceptability. TDF determinants across domains of capability, opportunity, and motivation were highlighted as contributing factors to provider behavior change. Step 5: Implementation/evaluation plans were developed. Conclusions Results reveal the FMF Connect Pro program was deemed acceptable and appears a promising method to expand FASD-informed care. A clinical trial is now underway (Step 6). Additionally, this study models an IM-Adapt approach that could be applied to increase broader adoption and implementation of EBIs.
Petrenko CLM, Myers J, Tapparello C et al.
Background Parent-implemented interventions (PIIs) are well established for improving developmental outcomes in autistic children. As evidence has accumulated, the field has increasingly shifted toward understanding for whom, and through which delivery formats PIIs can be most effectively implemented. These questions are pressing in non-Western contexts, where access to professional services is limited and culturally appropriate interventions are needed. This RCT, one of the largest of its kind in China, addressed this gap by comparing two scalable delivery formats (speech-language therapist [SLT]-led online groups vs. flexible Self-study format) of a culturally adapted social communication program and examining differential intervention responses and sustained engagement. Methods A total of 112 Chinese-speaking autistic children aged 24-60 months with limited spontaneous expressive language were randomized to a 20-week SLT-led or Self-study intervention. Autism severity, social functioning, and language skills were assessed at baseline, post-intervention, and 12 months after baseline. Parental stress, parenting sense of competence, and strategy use were also measured. Child, parent, and family baseline characteristics predicting differential outcomes and engagement were examined. Results No consistent differences between delivery formats were observed across most outcomes. Children's social functioning, expressive and receptive language showed improvement, and parental self-efficacy increased while stress decreased in both formats. Individualized analyses indicated greater benefits of the SLT-led format for children from lower-income families and those with greater developmental needs, whereas families with stronger baseline functioning showed comparable gains in the Self-study format. Attrition was higher in the Self-study format and was associated with lower child social skills and receptive languages, along with lower parental use of engagement-promoting behaviors and lower broader autism-related traits. Limitations Despite being one of the largest RCTs of its kind in China, the study may have been underpowered to detect small between-format differences, and the relatively modest sample size for the individualized machine-learning analyses limits the interpretation of these exploratory findings. Parental strategy use was measured using a general interaction coding scheme rather than intervention-specific behaviors. Higher attrition in the Self-study format warrants cautious interpretation, although sensitivity analyses supported the robustness of findings. Conclusions This study provides evidence supporting a culturally grounded PII associated with improvements in social functioning and language outcomes in autistic preschoolers, alongside increases in parental self-efficacy and reductions in parenting stress. Although no consistent differences between delivery formats were observed, SLT-led support appeared particularly beneficial for families with greater needs, whereas the Self-study format was sufficient for families with stronger baseline capacity, underscoring the importance of tailoring intervention formats to child and family characteristics. Trial registration ClinicalTrials.gov: NCT05635760, registered on 23 November 2022.
Wang L, Shi Y, So HC et al.
Background Gamified interventions for autistic children are becoming increasingly diverse, enhancing their presence, immersion, and sense of accomplishment to improve various social skill indicators. Existing systematic reviews have primarily evaluated intervention effectiveness from the perspectives of game design and intervention objectives. However, these findings are inconsistent and fail to inspect specific improvements in social skills among autistic children. Methods To address this gap, this study adopts a three-level meta-analysis approach from the perspective of AI-driven games, examining 14 relevant publications across 9 databases up to March 2026, totaling 37 effect sizes. At the same time, to understand the causes of heterogeneity, the study systematically examined the impact of seven moderating factors on intervention outcomes for autistic children: study design, sample size, intervention goals, measurement tools, intervention frequency, intervention duration, and artificial intelligence technology. Results The overall effect size of AI-driven gamified interventions on the social skills of autistic children was Hedges'g = 0.511 (95% CI [0.346, 0.677], p < 0.001), indicating a moderate positive effect. Specifically, regarding the improvement of social skills in autistic children through AI-driven games, the intervention targeting emotional expression and recognition achieved a moderate and significant effect size (Hedges'g = 0.536, p < 0.01), while the intervention targeting the dual development of attention and social skills reached a large effect size (Hedges'g = 0.963). The remaining skills, such as attention, communication skills, and daily living skills all reached a moderate effect size level (Hedges'g = 0.644, 0.650, 0.618). The moderating effect of AI technology was significant (Q(5) = 7.481, p < 0.001) and was primarily driven by differences in specific technology types rather than by complex hierarchical structures. Additionally, the study systematically identified 14 gamification elements and distilled the core components, including: feedback mechanisms, reward systems, and level design. Conclusion This study provides preliminary evidence that current AI-based gamified interventions can effectively improve the social skills of autistic children. However, it should be noted that this study has certain limitations. Future research should include more high-quality RCTs to explore the validity of intervention effects and systematically examine the optimal configuration of different combinations of AI technologies and gamification elements.
Lu H, Zhao J, Zhang Y et al.
Congenital heart disease (CHD) is the most common congenital malformation, affecting close to 9 per 1000 live births, and progressive advances in prenatal detection, surgical palliation, and perioperative care have transformed what was once an early-lethal condition into a chronic disease with a steadily expanding population of survivors reaching adolescence and adulthood [...].
Leo I, Marzano A, Avesani M
Childhood obesity is a major global public health challenge resulting from the interaction between changing food systems, dietary behaviors, and social inequalities. This Perspective argues that childhood obesity should be addressed through an integrated systems-based framework that links food environments, socioeconomic determinants, and emerging digital health technologies. Across Europe, children's dietary patterns have shifted toward increased consumption of ultra-processed foods and energy-dense products, alongside low adherence to healthy dietary guidelines. These trends disproportionately affect socially disadvantaged populations, reflecting persistent socioeconomic inequalities. Italy provides an informative case in which high levels of childhood overweight and obesity coexist with the cultural heritage of the Mediterranean diet, illustrating the gap between traditional dietary patterns and modern obesogenic environments. Although the Mediterranean diet remains a key model for healthy and sustainable eating, adherence is declining among younger generations, which points to the need for structural and educational interventions. Artificial intelligence (AI) and digital health technologies are being investigated as tools to support surveillance, early risk detection, and personalized nutrition strategies. However, evidence of sustained effectiveness in childhood obesity prevention remains limited, and any benefit will depend on equitable access, robust governance, and integration within existing health and education systems. Preventing childhood obesity therefore requires moving beyond exclusively individual-level interventions toward coordinated, multisectoral strategies that address food environments, social determinants of health, and equity. The combination of sustainable dietary models such as the Mediterranean diet, school- and community-based interventions, and responsibly implemented digital innovations may contribute to more effective and equitable prevention strategies.
Montagna MT, Caggiano G, De Giglio O et al.
Purpose Despite decades of attempts to "close the gap" between spoken language skills of deaf and hard of hearing (DHH) children and their hearing peers, this goal remains elusive. Retrieval practice is an empirically validated approach that could improve the acquisition and retention of language skills for DHH children. This study evaluates the effectiveness and efficiency of two key features of retrieval practice (feedback and spacing) for learning and retaining novel words. Method Using a single-case adapted alternating treatments research design, the thirteen 5- to 9-year-old DHH children were divided across four study contrasts. We compare the learning rates for novel words (for expressive, receptive, and semantic performance) under two retrieval practice conditions that differ by the presence of feedback or by spaced versus massed trials and a no-teaching control condition. The 4-week maintenance period permits analysis of retention once mastery is achieved and intervention ends, as is often observed clinically. Results Results were analyzed based on visual analysis and effect sizes. Nearly all participants learned and retained the novel words for at least one taught word set, which supports the effectiveness of the retrieval practice intervention. For efficiency, learning overall was faster with feedback than without and with spaced trials than massed trials, as predicted. Patterns were similar for expressive, receptive, and semantic outcomes. Conclusions The findings support use of retrieval practice with direct feedback and spaced trials to increase word learning efficiency for young DHH children. Continued investigation of variation across individuals and learning tasks is warranted. Supplemental material https://doi.org/10.23641/asha.32648916.
McDaniel J
Aim Imitation provides a foundation for acquiring a wide range of knowledge and skills; accordingly, early imitation may contribute to the development of later adaptive behavior encompassing conceptual, practical, and social skills. The present study examined whether imitation at 14 months predicts adaptive behavior at 8 years of age in a general population sample. Methods We analyzed data from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), a prospective birth cohort of children in Japan (n = 724). Adaptive behavior at 8 years of age was assessed using the Vineland Adaptive Behavior Scales, Second Edition (VABS-II), which served as the dependent variable. Hierarchical multiple regression analyses were conducted for each domain-level score of the VABS-II (communication, daily living skills, and socialization). Imitation at 14 months, assessed using the Japanese MacArthur Communicative Development Inventory, was entered as the primary predictor, along with relevant confounding variables. Results The imitation score at 14 months significantly predicted all three domains of adaptive behavior at 8 years, even after controlling for covariates, including children's developmental quotient, intelligence quotient, autism spectrum disorder traits, and demographic factors. The most substantial contribution was found in daily living skills, followed by socialization and communication. Conclusion Imitation in infancy was a significant predictor of later adaptive behavior, particularly in daily living skills and socialization. These findings suggest that early imitation may be related to learning processes essential for independent and cooperative living and may offer a clinically meaningful perspective on later functional outcomes, particularly adaptive behavior.
Kondo M, Shinohara A, Higuchi H et al.
