Environmental and social determinants of leisure-time physical activity in children with autism spectrum disorder

BackgroundIt is increasingly recognized that children's physical activity behaviors are shaped by neighborhood environment factors and their parent's support. However, these factors have been scarcely studied among children with autism spectrum disorder (ASD), a population at risk of inactivity.ObjectiveThis cross-sectional survey study was designed to examine how neighborhood environmental factors and parental support are related to physical activity levels of children with ASD. Also, this study examined if the relationship between the environment and physical activity is modified by demographic factors and COVID-19 related concerns.MethodsAn online survey was completed by parents of children with ASD aged 10–17 years. The questionnaire included items related to environmental factors (i.e., distance to school, distance to park, existence of sidewalks, walkability), parent support for physical activity (i.e., encouraging, watching, and providing transportation), child's physical activity, and demographic characteristics. The instrument also queried parental concerns about COVID-19 and their child's physical activity participation.ResultsThe results indicate that proximity to a local park and to school is positively associated with physical activity. Parent's encouraging behavior correlated with and predicted children's physical activity levels. Also, higher levels of COVID-19 related concerns among parents were related to decreased physical activity supporting behaviors.ConclusionsThis study demonstrated that the neighborhood environment, in particular the distance between home and parks and schools, and parent support behavior are influential factors that may shape physical activity behaviors for children with ASD.     

Parents' perception of their child's weight status and intention to intervene: a Western Australian cross‐sectional population survey, 2009–12

Objective: To report on parents' perceptions of their child's weight status and how the child's body mass index (BMI) is associated with parent intentions to change or maintain the child's weight. Methods: Estimates were derived via data collected from 4,437 parents from 2009 to 2012 as part of the Western Australian Health and Wellbeing Surveillance System. To measure weight perceptions, parents were asked, “Is your child underweight, normal weight, overweight or very overweight?” BMI values were also derived via parent‐reported height and weight. Parent intentions were assessed by asking parents, “What are your intentions regarding your child's weight?” Results: Significantly fewer parents perceived their child as overweight (8.2%) or very overweight (0.2%) than was derived via parent‐reported height and weight (16.3% and 5.8%, respectively). More than half the parents with children above or below the healthy BMI range reported an intention to “do nothing” about their child's weight (between 54.5% and 70.0%). Conclusions: A large proportion of Western Australian parents misjudge their child's weight status and the majority express no intention to help their child achieve a healthy weight. Implications: The results reinforce the importance of population‐level, parent‐focussed interventions targeting perceptions of children's weight and appropriate action.     

Happiness in Midlife Parental Roles: A Contextual Mixed Methods Analysis

This article focuses on midlife parental role satisfaction using date from a culturally diverse sample of 490 Metro Vancouver, British Columbia, Canada, parents. Results show that most parents are happy in their roles. Income satisfaction, intergenerational relationship quality, parents' main activity, health, age, ethnic background, and perceptions of how children “turn out,” however, influence their subjective levels of happiness. These findings are discussed in terms of practical implications for professionals interested in midlife parental health and well‐being.     

The Perceived Efficacy and Goal Setting System (PEGS), Part II: Evaluation of test–retest reliability and differences between child and parental reports in the Swedish version

Abstract

Objective: to evaluate the test–retest reliability of children's perceptions of their own competence in performing daily tasks and of their choice of goals for intervention using the Swedish version of the Perceived Efficacy and Goal Setting System (PEGS). A second aim was to evaluate agreement between children's and parents' perceptions of the child's competence and choices of intervention goals. Methods: Forty-four children with disabilities and their parents completed the Swedish version of the PEGS. Thirty-six of the children completed a retest session allocated into one of two groups: (A) for evaluation of perceived competence and (B) for evaluation of choice of goals. Cohen's kappa, weighted kappa and absolute agreement were calculated. Results: Test–retest reliability for children's perceived competence showed good agreement for the dichotomized scale of competent/non-competent performance; however, using the four-point scale the agreement varied. The children's own goals were relatively stable over time; 78% had an absolute agreement ranging from 50% to 100%. There was poor agreement between the children's and their parents' ratings. Goals identified by the children differed from those identified by their parents, with 48% of the children having no goals identical to those chosen by their parents. These results indicate that the Swedish version of the PEGS produces reliable outcomes comparable to the original version.     

The Long-Term Psychosocial Effects of Cancer Diagnosis and Treatment on Children and Their Families

Abstract

Using both qualitative and quantitative methods, a study of 77 families was undertaken to examine the long-term psychosocial effects of cancer on children and their families. This paper focuses specifically on the findings in relation to the parents' subgroup of the overall study. Key findings were that the majority of parents and their children readjust to ordinary family life following completion of treatment. Gender differences in parents' coping mechanisms emerged. The period immediately following the cessation of treatment can create feelings of isolation and vulnerability, and many parents have ongoing worries about their child's continued well-being.     

Acquisition of Multiple Languages Among Children of Immigrant Families: Parents' Role in the Home-School Language Pendulum

This study examined immigrant parents' role in their young children's language learning and development in linguistically different contexts in Chicago. At home the children lived with parents who spoke little or no English. At school the children were taught by mostly English speaking teachers, occasionally with teacher aides who spoke some of the other languages the children understood. The children had to operate in two linguistic worlds that were considerably different. The study sought to explain the means by which immigrant parents helped their children learn English effectively and also maintain their mother tongue. Five data collection instruments were used in the study: a parent questionnaire, an activity chart, audio recorders, an observation guide during home visits and parent interviews. The parent interviews were conducted towards the end of the study as a means to triangulate information and to crosscheck and clarify meanings of the data from the other instruments. The study revealed that parents' roles included different factors that supported children's learning of the languages. The factors included: the parents' attitudes towards language in general, parents' interest in both mother tongue and English, joint parent-child activities and direct, linguistic exchange between child and parent. Other factors included teacher flexibility, teacher-parent communication, parents' English classes school support, and parents' sensitivity to school support. Problems faced by parents and teachers included parents' lack of English proficiency to communicate effectively about children's school learning, and lack of effective linguistic link between home learning and school learning.     

Modeling caregivers' perceptions of children's need for formal care: physical function, intellectual disability, and behavior

BackgroundLike most caregivers, informal caregivers for children (typically parents) with special needs supply the majority of the care provided. Formal care is sometimes needed to supplement informal caregivers' efforts. For those interested in children with special needs, there is a paucity of research on those factors affecting the amount of formal care that caregivers' request.Objectives/HypothesesThis research investigates factors affecting the amount of Medicaid personal care services (PCS) requested by primary caregivers for children with special needs. The research focuses especially on the roles played by the child's functional status, intellectual abilities, and behaviors in determining the level of assistance requested by caregivers.MethodsThe data used in this research are cross-sectional information on 262 children with special needs who were Medicaid recipients in a single southwestern state. These data were collected in 2007 by master's trained social workers or registered nurses using a standardized assessment instrument.ResultsThe results indicate that a child's ability to independently perform activities of daily living (ADLs) tasks plays the major role in determining caregivers' perceptions of the need for PCS. The severity of a child's intellectual disability, like some other factors investigated, has an effect on caregivers' perceptions, but it is an indirect effect that operates through the level of the child's ADL impairment. A child's age and behaviors have direct effects on caregivers' perceptions of need, as does the presence of barriers to the caregiver providing care.DiscussionMuch of the research on children with special needs has emphasized the importance of the child's medical or behavioral diagnoses. Little attention has been given to modeling caregivers' perceptions of children's needs. This analysis of caregivers' requests for formal PCS brings to the forefront the role of ADL or functional status in this process. Many factors that one would expect to directly affect caregivers' perceptions of need, instead, have indirect effects filtered through their impact on the child's functional status.     

Parent Perspectives on Nutrition and Physical Activity During Out-of-School Time

ObjectiveOut-of-school time (OST) programs serve a large, diverse population of children, including those at increased obesity risk. In this study, parents' perspectives about nutrition and physical activity (PA) during OST were assessed.DesignSurvey.SettingOnline.ParticipantsSix hundred parents with a school-aged child participating in programs from selected OST organizations.Main Outcome MeasuresParent perspectives about the importance and availability of different foods, beverages, and PA opportunities during OST, and OST program and parent involvement in promoting healthful environments.AnalysisFrequencies were used to describe parents' perspectives. Wilcoxon tests and logistic regression analyses were conducted to test for significant differences.ResultsMost parents reported that it was important that their children have water (96.2%), fresh fruits and vegetables (79.0%), and PA (97.2%) during OST; fewer parents reported that these were regularly available. About two thirds of parents agreed that OST programs should promote healthy environments for children, whereas one third agreed that parents alone should be responsible for children's nutrition and PA.Conclusions and ImplicationsResults suggest that many parents would support efforts to improve OST nutrition and PA. Yet, there is a need to further understand the perceptions and motivations of different subgroups to enact successful obesity prevention efforts during OST.     

The Relationship Between Classroom Quality and Ratings of the Social Functioning of Head Start Children

Classroom quality throughout three Head Start programs in the southeastern United States was monitored. A random sample of classrooms was selected to represent high and low quality classrooms in urban and rural settings. Parents and teachers rated the social behaviors of 328 children who were nested within 40 classrooms. Maternal depression was associated with parent reports of fewer positive social behaviors and more problem behaviors. Parent-reported home violence was associated with fewer disruptive behaviors as reported by the teacher. Higher quality classrooms tended to have lower scores on a parent-reported measure of children's problem behaviors. Teachers who interacted less positively with children tended to rate the children in their classrooms as more compliant. The teacher's ability to individualize instruction tended to moderate the association between the child's age and prosocial behaviors while also moderating the association between maternal depression and parents' reports of their children's problem behaviors.     

Tourette syndrome,parenting aggravation,and the contribution of co-occurring conditions among a nationally representative sample

BackgroundPrevious research suggests that parents of a child with Tourette Syndrome (TS) have lower self-concepts, higher caregiver burden, and more difficulties with home activities. However, the contributions of TS and mental, emotional, or behavioral (MEB) conditions to family functioning are difficult to identify from previous research due to relatively small TS sample sizes and high rates of co-occurring conditions within samples of children with TS.ObjectiveThe current study hypothesized that families of children with TS would report significantly more family functioning difficulties (more parenting aggravation, more difficulty with coping with the child's care, less parent–child communication, and less consistent family routines). Specifically, co-occurring conditions would contribute substantially to reported parenting aggravation.MethodParent-reported data from the 2007 National Survey of Children's Health were analyzed, including whether the child had been diagnosed with TS or an MEB. Weighted analyses were restricted to US children 6–17 years of age (n = 64,034) and adjusted for child age, sex, race and ethnicity.ResultsParents of children with TS were more likely to fall into the high parenting aggravation index category compared with parents of children without TS (aPR = 3.8, 95% CI: 2.2–6.6). Controlling for the co-occurring MEB conditions attenuated the relations between TS and parenting aggravation; however, a significant effect for TS remained in some cases.ConclusionParents of children with TS may face significant challenges in raising their children, leading to increased parenting aggravation; these challenges appear to be primarily associated with the presence of co-occurring MEB conditions.     

Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children

ObjectivesTo examine the agreement between children's and parents' reporting of illness-related absenteeism from school and to examine predictors for disagreement between children and parents.Study Design and SettingA total of 8,438 schoolchildren aged from 5 to 15 years (grade 0–8) and one parent of each child were invited to participate in the Hi Five baseline study. The response rate for children answering a questionnaire was 89% (n = 7,525), and 36% of the parents (n = 3,008) participated in a weekly illness registration study using text messages (short message service) over a period of 22 weeks. Text messages and questionnaire data were linked at the individual level, leaving 2,269 child–parent pairs in the analysis, corresponding to 27% of the eligible sample.ResultsThe agreement between children's and parents' reports of illness-related absenteeism was good, with high absolute agreement and slight to moderate Ƙ values. Agreement was lowest for 6- to 8-year-olds and highest for 11- to 12-year-olds. Children's reports of illness symptoms and parents' reports of their children's illnesses in the preceding week were strong predictors for children reporting illness-related absenteeism when parents did not.ConclusionIllness-related absenteeism can be reported by children, and children report higher prevalence of illness-related absenteeism than parents.     

Factors Related to Parenting Practices in Taiwan

The purpose of this study was to examine factors related to authoritative and authoritarian parenting practices in Chinese mothers with preschoolers. This study not only focused on the global parenting typologies ( e.g. authoritative and authoritarian parenting), but also looked into the individual component elements of authoritative and authoritarian parenting. Belsky's (1984) ecological model was used to select potential predictors of parenting practices: 1) characteristics of the mother, 2) characteristics of the child, and 3) contextual factors. The sample consisted of 463 mothers with their preschool children in Taiwan. Mothers were administered a questionnaire which assessed their parenting practices, Chinese parenting beliefs, depression level, degree of parenting daily hassles, child's age, perception of the child's temperament, and demographic information. As expected, maternal characteristics, child characteristics, and contextual factors predicted mothers' parenting practices. The results suggested that maternal depression, child temperament, and degree of parenting daily hassles might have cross-culturally universal influences on parenting practices. However, the significant influence of culturally specific parenting beliefs on parenting was also found. Chinese parents' use of authoritative and authoritarian parenting were both in some degree embedded in traditional Chinese parenting beliefs - the concept of training.     

Parents' experiences of living with a child with hydrocephalus: a cross‐sectional interview‐based study

Background

Shunts, the main treatment for hydrocephalus, are problematic because they frequently malfunction. Detecting shunt malfunction is challenging because symptoms are similar to those of common childhood illnesses, particularly viral infections. Parents are responsible for identifying shunt malfunction and responding accordingly. Understanding parents'' experiences has the potential to improve parent–professional collaboration and the management of the child''s condition.

Aim

To explore parents'' experiences of living with a child with hydrocephalus and their decisions when they suspect shunt malfunction.

Design and methods

A cross‐sectional interview‐based survey using qualitative methods was undertaken. Twenty‐five parents participated in the interviews. Framework approach underpinned data analysis.

Findings

Three concepts, ‘uncertainty’, ‘developing expertise’, and ‘a normal life’, were identified. These concepts were dynamic in nature as parents learned through experience, adapted to changes in their child''s health status and made decisions about their needs. Uncertainty because of the unpredictability and life‐threatening nature of shunt malfunction dominated parents'' accounts. Through experience, parents learned to differentiate between symptoms that suggested a shunt problem and those of other childhood illnesses, but perceived their expertise was not always valued by health professionals or used to inform clinical decisions. Decisions about where or when to seek advice related to prior experiences of health‐care services and minimizing disruption for the whole family.

Conclusion

Parents can recognize illness symptoms suggestive of shunt malfunction and want to collaborate with health professionals about the management of their child''s condition. Collaboration with parents requires health professionals to listen to parents'' concerns and value their experiences.     

Associations Between Parental Concern for Adolescent Weight and the Home Food Environment and Dietary Intake

ObjectiveExamine associations between parental concern about adolescent weight and adolescent perceptions of their dietary intake, home food availability, family mealtime environment, and parents' feeding practices.DesignCross-sectional study.SettingAdolescents, aged 12-15 years from 37 secondary schools in Victoria, Australia, and their parents completed surveys in 2004-2005.Participants1,448 adolescent–parent pairs.Main Outcome MeasuresParental concern about adolescent weight; adolescent perceptions of their food intake and home food environment.AnalysisChi-square tests, exploratory factor analysis, independent t tests (P < .01).ResultsAlthough 12% of parents perceived their adolescent as overweight, 27% were concerned about their adolescent's weight (under- or overweight). Adolescents of concerned parents reported lower intakes of energy-dense snacks and less home availability of these food items, and they perceived that their parents less often listened to and considered their food preferences when shopping and cooking, than did adolescents of unconcerned parents. Concerned parents were no more likely to provide fruits and vegetables in the home or a positive family mealtime environment than unconcerned parents, at least as reported by their adolescents.Conclusions and ImplicationsParental concern about adolescent weight was associated with lower intakes of energy-dense snacks among adolescents, less home availability of these food items, and less supportive parental feeding practices. Parents should be encouraged to listen to and consider their adolescents' food preferences, and provide supportive family mealtime environments and healthful food in the home.