Machine-learning techniques are suitably employed for gait-event prediction from only surface electromyographic (sEMG) signals in control subjects during walking. Nevertheless, a reference approach is not available in cerebral-palsy hemiplegic children, likely due to the large variability of foot-floor contacts. This study is designed to investigate a machine-learning-based approach, specifically developed to binary classify gait events and to predict heel-strike (HS) and toe-off (TO) timing from sEMG signals in hemiplegic-child walking. To this objective, sEMG signals are acquired from five hemiplegic-leg muscles in nearly 2500 strides from 20 hemiplegic children, acknowledged as Winters' group 1 and 2. sEMG signals, segmented in overlapping windows of 600 samples (pace = 5 samples), are used to train a multi-layer perceptron model. Intra-subject and inter-subject experimental settings are tested. The best-performing intra-subject approach is able to provide in the hemiplegic population a mean classification accuracy (±SD) of 0.97±0.01 and a suitable prediction of HS and TO events, in terms of average mean absolute error (MAE, 14.8±3.2 ms for HS and 17.6±4.2 ms for TO) and F1-score (0.95±0.03 for HS and 0.92±0.07 for TO). These results outperform previous sEMG-based attempts in cerebral-palsy populations and are comparable with outcomes achieved by reference approaches in control populations. In conclusion, the findings of the study prove the feasibility of neural networks in predicting the two main gait events using surface EMG signals, also in condition of high variability of the signal to predict as in hemiplegic cerebral palsy.
Christian Morbidoni, Alessandro Cucchiarelli, Valentina Agostini et al.
BACKGROUND: Executive functions (EFs) are critical in school and closely linked to academic achievement and learning-related behaviours (LRBs). LRBs encompass the ability to adapt to school demands, including concentration, adherence to rules, and autonomy. AIMS: This correlational study aimed to examine the mediating role of LRB in the association between EF and academic achievement in the first year of primary school. SAMPLE AND METHOD: Ninety-five first graders underwent a performance-based EF assessment, involving tasks related to working memory and inhibition. Concurrently, they completed literacy and math tasks, while their teacher provided reports on their LRBs. RESULTS: The results indicate that depending on the specific EF component or learning domain considered, diverse patterns emerge. Nevertheless, the findings consistently show that EFs are directly and indirectly associated with learning outcomes, with the mediating influence of LRBs. CONCLUSIONS: These results emphasize the importance of supporting EF development into early education curricula.
Background Screens have become an integral part of the daily lives of children and young people and play a crucial role in both educational and leisure activities. The aim of this scoping review was to explore and map the existing evidence on the potential influence of recreational screen use on concentration ability and learning in individuals aged 6–25 years. Methods A search of the literature published between 2013 and 2023 was performed in three databases (PsycINFO, CINAHL, and Web of Science). The search was conducted using relevant search terms related to screen use, concentration and learning, and children, adolescents, and young adults. Inclusion criteria included reviews, meta-analyses, cohort studies, cross-sectional studies, and experimental studies. Data was synthesized using thematic analysis Results A total of 33 original studies and reviews were included and encompassed a close to equal distribution in terms of age groups. Of these studies and reviews, 33 % examined screen time, 58 % media multitasking, 27 % gaming, and 6 % television viewing. The results of the studies indicated that excessive screen time was associated with concentration difficulties, which suggests that the associations are bidirectional. Some studies identified poor sleep quality, influenced by pre-bedtime screen use, as a mediating factor. Recreational media multitasking in school settings was consistently correlated with inferior learning outcomes, whereas studies on television use and gaming showed inconsistent results. Conclusion Findings from this scoping review suggest a small yet consistent correlation between screen use and concentration difficulties among children and young people. Further research is needed to establish causal relations and to examine how different aspects and uses of screens affect concentration.
INTRODUCTION: Exposure to poor environmental conditions has been associated with deterioration of physical and mental health, and with reduction of cognitive performance. Environmental conditions may also influence cognitive development of children, but epidemiological evidence is scant. In developed countries, children spend 930 hours per year in a classroom, second only to time spent in their bedroom. Using continuous sensing technology, we investigate the relationship between indoor environmental quality (IEQ) and cognitive performance of school-aged children. The proposed study will result in a better understanding of the effects of environmental characteristics on cognitive performance, thereby paving the way for experimental studies. METHODS AND ANALYSIS: A study protocol is presented to reliably measure IEQ in schools. We will monitor the IEQ of 280 classrooms for 5 years, covering approximately 10 000 children. Each classroom in the sample is permanently equipped with a sensor measuring air quality (carbon dioxide and coarse particles), temperature, relative humidity, light intensity and noise levels, all at 1 min intervals. The location of sensing equipment within and across rooms has been validated by a pilot study. Academic performance of school-aged children is measured through standardised cognitive tests. In addition, a series of health indicators is collected (eg, school absence and demand for healthcare), together with an extensive set of sociodemographic characteristics (eg, parental income, education, occupational status). ETHICS AND DISSEMINATION: Medical Ethical Approval for the current study was waived by the Medical Ethical Committee azM/UM (METC 2018-0681). In addition, data on student performance and health stems from an already existing data infrastructure that are granted with ethical approval by the Ethical Review Committee Inner City faculties (ERCIC_092_12_07_2018). Health data are obtained from the 'The Healthy Primary School of the Future' (HPSF) project. Medical Ethical Approval for HPSF was waived by the Medical Ethical Committee of Zuyderland, Heerlen (METC 14 N-142). The HPSF study protocol was registered in the database ClinicalTrials.gov on 14-06-2016 with reference number NCT02800616, this study is currently in the Results stage. Data collection from Gemeentelijke Gezondheidsdienst Zuid-Limburg (GGD-ZL) is executed by researchers of HPSF, this procedure has been fully approved by the Medical Ethical Committee of Zuyderland. The questionnaires on level of comfort will be filled in anonymously by students and teachers. The study will follow the EU General Data Protection Regulation (EU GDPR) and Dutch data protection law to ensure protection of personal data, as well as maintain proper data management and anonymisation.The protocol discussed in this paper includes significant efforts focused on integrating results and making them available to both the scientific community and the wider public, including policy makers. The results will lead to multiple scientific articles that will be disseminated through peer-reviewed international journals, as well as through conference presentations. In addition, we will exploit ongoing collaboration with project stakeholders and project partners to disseminate information to the target audience. For example, the results will be presented to school boards in the Netherlands, through engagement with the Coalition for Green Schools, as well as to school boards in USA, through engagement with the Center for Green Schools. TRIAL REGISTRATION NUMBER: NCT02800616; Results.
Juan Palacios, Piet M. A. Eichholtz, Maartje Willeboordse et al.
As prenatal exposure to certain older antiseizure medications (ASMs) has been linked with poorer neurodevelopmental outcomes in children, the use of newer ASMs throughout pregnancy has increased. The current review aimed to delineate the impact of in utero exposure to these newer ASMs on child neurodevelopment. A systematic search of MEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature Plus, and PsycINFO was conducted, limiting results to articles available in English and published after the year 2000. Studies investigating neurodevelopmental outcomes following in utero exposure to the following ASMs were eligible for inclusion in the review: eslicarbazepine, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, topiramate, and zonisamide. Thirty-five publications were identified, and a narrative synthesis was undertaken. Methodological quality was variable, with distinct patterns of strengths/weaknesses attributable to design. Most studies examined lamotrigine exposure and reported nonsignificant effects on child neurodevelopment. Comparatively fewer high-quality studies were available for levetiracetam, limiting conclusions regarding findings to date. Data for topiramate, gabapentin, and oxcarbazepine were so limited that firm conclusions could not be drawn. Concerningly, no studies investigated eslicarbazepine, lacosamide, perampanel, or zonisamide. Exposure to certain newer ASMs, such as lamotrigine and levetiracetam, does not thus far appear to impact certain aspects of neurodevelopment, but further delineation across the different neurodevelopmental domains and dosage levels is required. A lack of data cannot be inferred to represent safety of newer ASMs, which are yet to be investigated.
Rebecca A. Knight, Anja Wittkowski, Rebecca Bromley
Parents’ involvement and engagement with their child’s school and learning are important in children’s educational outcomes and their overall life successes, and both parental involvement and engagement are seen to be socioeconomically distributed. This paper aims to explore to what extent and how parents from areas of socioeconomic deprivation are involved in their children’s school and engaged in their children’s learning. Semi-structured interviews were conducted with children, parents, and school staff from four schools in areas of socioeconomic deprivation across Wales. These interviews primarily explored parental involvement with schools and parental engagement with learning. Findings revealed that parents were involved in a range of parental involvement activities and events. However, there were differences in the levels of parental engagement reported by families and schools, with schools reporting limited parental engagement with learning. Variations stemmed from differences in how parents and schools conceptualised “learning”. Barriers to parental involvement and engagement showed schools’ limited understanding and consideration of the poverty faced by families, and deficit approaches towards parents were evidenced. To understand parental engagement with learning further, there is a need for a broader conceptualisation of learning and its value, to encompass non-academic and less formal development opportunities. Further research to explore and assess the impact of parental engagement with learning, both formal and informal, on children’s academic and non-academic outcomes is recommended. In addition, the research recommends schools attempt to further understand the complexities of families and their wider environment to tailor involvement and engagement approaches.
BACKGROUND: School closure created difficulties for parents, who were asked to care for their children and help them with schooling, while working at home. We aimed to explore the experiences in organising school for children at home and its implications on children's psychological well-being and educational progress during the quarantine for the COVID-19 pandemic. METHODS: A nationwide online survey of mothers of primary and middle school students was conducted during the COVID-19 pandemic. Demographic data and information on distance learning organisation and children's attitudes and behavioural changes were collected. RESULTS: 2149 mothers completed the survey, with a final sample of 1601 subjects. Large differences between primary and middle school emerged: lessons were less organised and routines were more instable for the youngest, who could not pay attention for more than 20 min (28.3%) and needed breaks every 10 min (21.6%), with lower quality of learning (40.6%), increased restlessness (69.1%), and aggressiveness (33.3%). A large use of screens was reported, with an abuse in screen time in 2%. Two thirds of mothers did not approve of distance learning (72.2%) because of their role in replacing teachers (77.8%), the effort required (66%), and the great commitment required (78.3%). CONCLUSIONS: Distance learning increased educational deprivation and social inequalities, especially for the youngest children, who lost almost one year of school. The situation was even worse for children with disabilities, who were neglected by the institutions. This period should be considered as an opportunity to correct the weaknesses of our school system.
Francesca Scarpellini, Giulia Segre, Massimo Cartabia et al.
Abstract Background Outdoor education (OE) is a teaching method aiming to promote children’s learning, physical activity (PA) and wellbeing. OE in green areas may further increase positive effects. There is little knowledge on use of OE and its possible effects in a Finnish context. Also, there is a need to evaluate OE from a teacher perspective. The aim of the LärMiljö-study is to: a) survey the use of OE in Swedish-language primary schools and investigate factors related to its use; b) investigate the associations between OE and PA, wellbeing, nature relations and learning among children aged 9-13 years, considering other related factors. Methods The self-determination theory (SDT) is used as theoretical framework. Data is collected via electronic surveys in Swedish-language primary schools, including: a) national surveys among principals and teachers; b) surveys among children and guardians. Children’s PA is measured for a 7-day period via accelerometers and a diary is kept. Teachers keep a class diary on OE provided. Academic tests are performed. Data will be analyzed using quantitative methods. Results This abstract describes the study protocol. The investigation of associations between OE and outcomes among children is mainly done by comparing classes that regularly use OE with classes that do not. Main outcomes are PA, psychosocial wellbeing, academic performance and nature connectedness; secondary outcomes are school motivation, social relations and sleep. Teachers’ experience and use of OE is explored, as is perceived effects of and barriers to OE use. Based on SDT, associations between OE and need satisfaction at work, competence, motivation and work engagement are studied. Conclusions The study represents a unique opportunity to explore OE use in primary schools, its effects among children and teachers, and what the supporting and hindering factors for its use are. The study contributes knowledge that can be used to promote learning and wellbeing in school. Key messages • Outdoor education in primary school may promote schoolchildren’s learning, physical activity, wellbeing and nature relation, but more knowledge is needed, including the perspective of teachers. • The LärMiljö-study will broaden the understanding of the potential effects of OE in primary education and school health promotion, and on factors supporting and hindering its use.
We evaluated environmental values of primary school children during a one-day program at a wildlife park and compared the outcomes concerning two different forms of instruction (teacher-centered, student-centered) as well as two different surroundings of learning settings (wildlife park, school) while observing state emotions. A total of 441 primary school children (average age 8.87 ± 0.56 years) learned about the importance of preserving the habitat of the European wildcat. A questionnaire based on an established model was administered. Students' preservation values changed significantly at the wildlife park as well as at school with no significant differences between forms of instruction and state emotions overall.
Previous research in children has shown that higher cardiovascular fitness is related to better executive functioning. However, the available literature is hampered by methodological limitations. The present study investigates the relationship between cardiovascular fitness and executive functioning in a large sample of healthy children (N = 814). Cardiovascular fitness was assessed with estimated VO2Max from 20 m Shuttle Run Test performance. Executive functioning was assessed using a set of computerized neurocognitive tasks aimed at executive functions (working memory, motor inhibition, interference control) and lower-level neurocognitive functions (information processing and attention). Dependent measures derived from the neurocognitive tests were subjected to principal component analysis. Mixed model analyses tested the relation between cardiovascular fitness and neurocognitive functioning components. Results showed that children with higher cardiovascular fitness performed better on the neurocognitive function components Information Processing and Control, Visuospatial Working Memory and Attention Efficiency. The following measures contained in these components contributed to the observed relations: information processing measures, visuospatial working memory, and speed of alerting attention. No relationship was found between cardiovascular fitness and the other components: Verbal Working Memory, Attention Accuracy, and Interference Control. The present study suggests that there is a relationship between cardiovascular fitness and a specific set of executive functions and lower level neurocognitive functions. These findings highlight the importance of cardiovascular fitness for the overall health of school-aged children.
Anna Meijer, Marsh Königs, Anne G. M. de Bruijn et al.
