Parents' view of the cognitive outcome one year after pediatric epilepsy surgery.

OBJECTIVES: The cognitive outcome of pediatric epilepsy surgery has mainly been examined on the basis of standardized tests. Here, we analyzed the outcome in six cognitive domains from the parents' view. METHODS: Included were consecutive surgical pediatric patients whose parents filled-in a comprehensive questionnaire on cognitive problems in children and adolescents (Kognitive Probleme bei Kindern und Jugendlichen (KOPKIJ); Gleissner et al. 2006) at the preoperative baseline (T1) as well as twelve months thereafter (T2). All children also underwent standard neuropsychological assessments at T1 and T2. RESULTS: Parents of 96 patients provided pre- and postoperative KOPKIJ data. Overall, 80% of the children became seizure-free at the follow-up. Group means indicated a strong positive effect of time on KOPKIJ and neuropsychological performance. We found postoperative improvements in five out of six cognitive domains (language, memory, executive functions, attention, school; unchanged: visuospatial abilities). Individually, improvements were twice as likely as declines. However, 33 patients (35%) experienced significant decline in at least one cognitive domain. Later onset of epilepsy resulted in better performance but had no effect on change scores. Seizure-free status, lower antiseizure drug load, and stronger drug reduction after surgery contributed to postoperative cognitive improvements as perceived by the parents; no other effects of clinical factors were obtained (e.g., localization/lateralization). Despite their similar outcome patterns, change scores as derived from parental ratings and neuropsychological assessment were not correlated. CONCLUSIONS: Parents acknowledged the overall positive neurocognitive development after pediatric epilepsy surgery as previously shown by standardized tests. Seizure freedom and lower antiseizure drug load contributed to the beneficial cognitive outcome. Even if cognitive improvements outweighed declines, a risk for cognitive decline with impact on everyday functioning does exist.

[The Role of Internet Parenting for the Internet use of Children in Pre-, Primary and Secondary School]. / Die Bedeutung der elterlichen Interneterziehung für die Internetnutzung von Vor-, Grund- und Sekundarschulkindern.

The Role of Internet Parenting for the Internet use of Children in Pre-, Primary and Secondary School The present study analyzes the relationship between mothers' and fathers' Internet parenting and children's Internet use across different age groups (1-15 years). Especially, we looked at the influencing factors of parental mediation strategies and the interplay of mothers' and fathers' Internet parenting. Based on data of the DJI-survey "Growing up in Germany" (Aufwachsen in Deutschland: Alltagswelten, AID:A II 2015, N = 1,196), dyadic structural equation models have shown that across all age groups shared parent-child online activities were important influencing factors of regulating the children's Internet use. Also, the self-perceived Internet education competence of mothers and fathers has been confirmed as a relevant factor influencing a more intense use of parental mediation strategies for school-aged children. While the amount of Internet use among young children (1-6 years) was exclusively influenced by features and strategies of mothers' Internet parenting, the transition to elementary school not only marked changes in the frequency of children's Internet use, but also in the ICT parenting of mothers and fathers. For school-aged children, we indeed found an influence of fathers as well as, in case of the oldest age group, a reduced use of parental mediation strategies. However, parents' attitudes, competences and strategies regarding Internet parenting still stayed important during adolescence.

Food texture experiences across nine age groups in Indian infants from urban areas.

The introduction of complementary food plays a fundamental role in dietary behaviours later in life. Little is known about the influences of age on food texture acceptance in young Indian children. Thus, the objective of this cross-sectional study was to describe the relationship between age and food texture experiences in young children aged 4-36 months in India from urban areas using a parental-reported survey. This study relies on a face-to-face parent survey, which was conducted comprising 306 children categorised into 9 age groups. Questions focussed on food texture experience considering 16 textures were analysed. Textures such as dissolvable, sticky, and soupy/liquidy were already accepted by more than half of 4-5-month-old infants. In India, soupy/liquidy is a more common base texture than pureed. Indeed, pureed was found to be introduced to a majority of infants only from 8 to 9 months onwards. Food textures such as rubbery, slippery, and foods with skin were more likely rejected by the youngest children. With increasing age, the refusal probability of food textures decreased. Our survey showed food texture experiences in Indian children aged from 4 to 36 months. It provides useful insights for parents and healthcare professionals by contributing to the understanding of texture acceptance during the transition to complementary foods.

Parental Beliefs About the Causes, Treatments, and Medical Assistance for Children With Nocturnal Enuresis in the Eastern Region of the Kingdom of Saudi Arabia.

OBJECTIVE: To assess parental beliefs about the causes, treatment, and necessity for medical assistance for children with nocturnal enuresis (NE). METHOD: A self-administered survey questioned parents' beliefs about NE, including causes and at-home behavioral therapy. We evaluated the association between demographic characteristics and the tendency to seek medical advice for NE. RESULT: The questionnaire received responses from 1232 individuals, 77.1% of whom were female and 82.9% of whom were 30 years of age or older. Psychological issues (53.5%) and laziness to get up (47.6%) were the most often believed causes of NE. Two frequent at-home behavioral therapies chosen by participants were voiding before bedtime and restricting fluid intake at night (73.4% and 70%, respectively). However, only 6.9% of respondents believe that a bedwetting alarm is an effective treatment. The two most frequently reported reasons for not seeking medical attention were parents' belief that their child will eventually outgrow bedwetting (34.1%) and "parents or children's embarrassment" (21.8%). The chi-squared test was used to evaluate the association between demographic characteristics and seeking medical advice. Participants with a single child were more likely than those with more than three children to take their child to the doctor (61.5% vs. 48.6%, respectively). Also, parents who don't have NE-afflicted children were more open to consider seeking medical advice for NE therapy (if their children developed it in the future) compared to parents who already have children with NE. CONCLUSION: Parents in the Eastern region of Saudi Arabia hold various misconceptions about the causes and treatment of NE. Only 52.1% of parents would take their child to see a doctor if wetting the bed and only 48.1% of parents were aware of effective treatments for NE. These results emphasize that healthcare practitioners need to provide proper information to raise public awareness of NE.

Parental Beliefs and Attitudes Toward the Use of Baby Walkers in the Eastern Region of Saudi Arabia.

Background Baby walkers (BWs) are popular among parents worldwide, despite safety concerns and developmental impact concerns, as they are influenced by cultural beliefs, social myths, and personal interests. This study aims to assess parental beliefs and attitudes toward the use of BWs in the Eastern region of Saudi Arabia. Materials and methods A descriptive cross-sectional study was conducted among 400 mothers in the Eastern region of Saudi Arabia. Data were collected through an online questionnaire, which included demographic information, BW usage, reasons for usage/non-usage, and awareness of the dangers and disadvantages of BWs. Descriptive statistics and chi-square tests were used for data analysis. Results Among the participants, 332 (83.0%) reported using BWs for their children. The majority of parents i.e. 237 parents (71.3%) used walkers for their child's fun and 146 parents (43.9%) used them for 1-2 hours daily. Among the reasons for non-usage, concerns about affecting the child's walking and potential injuries were most common in 29 (42.6%) and 28 (41.1%) parents, respectively. Significant associations were found between mother's age, child's birth order, age of crawling, age of independent walking, and BW usage. Forty-eight children (14.4%) who used walkers experienced injuries, including falling downstairs 20 (41.6%) and flipping over on a flat surface 21 (43.7%). Conclusion This study highlights the prevalence of BW usage and the reasons behind parental decisions in the Eastern region of Saudi Arabia. While many parents use BWs to promote early walking and provide entertainment, concerns about safety and potential developmental impacts persist.

Parental perspectives on Phelan-McDermid syndrome: Results of a worldwide survey.

Phelan-McDermid syndrome (PMS) is a rare neurodevelopmental disorder characterised by hypotonia, speech problems, intellectual disability and mental health issues like regression, autism and mood disorders. In the development, implementation and dissemination of a new clinical guideline for a rare genetic disorder like PMS, the parental experienced perspective is essential. As information from literature is scarce and often conflicting the European Phelan-McDermid syndrome guideline consortium created a multi-lingual survey for parents of individuals with PMS to collect their lived experiences with care needs, genotypes, somatic issues, mental health issues and parental stress. In total, we analysed 587 completed surveys from 35 countries worldwide. Based on parental reporting, PMS appeared to be caused by a deletion of chromosome 22q13.3 in 78% (379/486) of individuals and by a variant in the SHANK3 gene in 22% (107/486) of the individuals. Parents reported a wide variety of developmental, neurological, and other clinical issues in individuals with PMS. The most frequently experienced issues were related to speech and communication, learning disabilities/intellectual disability, and behaviour. While most reported issues were present across all age groups and genotypes, the prevalence of epilepsy, lymphoedema, and mental health issues do appear to vary with age. Developmental regression also appeared to begin earlier in this cohort than described in literature. Individuals with PMS due to a 22q13.3 deletion had a higher rate of kidney issues and lymphoedema compared to individuals with SHANK3 variants. Parental stress was high, with specific contributing factors being child and context related in accordance with the PMS phenotype. The survey results led to various validated recommendations in the European PMS guideline including an age specific surveillance scheme, specific genetic counselling, structured healthcare evaluations on sleep and communication and a focus on family well-being.

Linking Gaming Disorder Tendencies in Children to Their Personality and Parental Gaming Behavior.

Playing computer and video games (so-called gaming) is of great popularity among children and adults. But for some people, gaming gets out of hand and can result in a Gaming Disorder (GD). Among others, high neuroticism and low conscientiousness are considered to play a role in the etiology of GD. Next to personality traits, environmental variables are debated such as the parental influence on children's gaming behavior. In detail, parental gaming behavior could have role model functions for children. Based on empirical observations and theoretical frameworks, it was hypothesized that higher tendencies to GD in children are associated with higher neuroticism, lower conscientiousness, and higher parental tendencies to GD. In an online survey N = 493 parents (n = 472 females; age: M = 36.30, SD = 5.46) rated their own and their children's (n = 233 girls, n = 260 boys; age: M = 6.03, SD = 2.30) tendencies to GD by the Gaming Disorder Test (GDT) and their children's personality by the Big Five Inventory (BFI). Neuroticism was significantly correlated with the GDT scores of boys (rho = 0.256, p = 0.001) and girls (rho = 0.300, p = 0.001), while a significant correlation with conscientiousness was only present for boys (rho = -0.196, p = 0.010). Parents' and children's general playing of computer and video games were interdependent [χ2(1) = 29.14, p < 0.001]; hence, if parents reported to be gamers, their children were more likely gamers as well. The GDT scores of parents and children were positively correlated (boys: rho = 0.36; p = 0.002; girls: rho = 0.33, p = 0.004). The results indicate that already in children the personality traits neuroticism and conscientiousness are associated with tendencies toward GD. Moreover, as gaming of parents and children was related to each other, it is conceivable that parents influence their children's gaming behavior via their own gaming behavior. Therefore, parents should be aware of their exemplary function for children and may overthink their own gaming behavior. But it has to be mentioned that the correlational nature of the present work allows no insights regarding causal relations.

Parental views on attending neonatal intensive care ward rounds.

OBJECTIVES: To ascertain parental views regarding taking part in neonatal unit ward rounds. DESIGN: A service evaluation project. SETTING: Tertiary neonatal intensive care unit. PATIENTS: Parent(s) of infants receiving care on the neonatal unit. INTERVENTIONS: Structured interviews conducted at the cot side. MAIN OUTCOME MEASURES: Parents were asked if they knew when ward rounds occurred, whether they had attended ward rounds and if they had not what were the factors inhibiting them from doing so, their experience of attending ward rounds and whether they were concerned about issues of confidentiality. RESULTS: 23 of 24 consecutive parents agreed to be interviewed. The median age of their infants was 14 (range 3 - 123) days when they were interviewed. Eighty-five per cent were able to identify when a nursing handover or doctor's ward round occurred. Seventy-five per cent of parents had attended at least one ward round and the median score in terms of usefulness was 5 out of 5. Reasons for not attending included time and cost to travel to the unit, their partners were working and having other children. Parents volunteered that the nurses proactively updated them as soon as they arrived, hence making regular attendance less important. Regarding confidentiality, 85% were not concerned if other people overheard information about their baby, unless the news was bad. CONCLUSIONS: Parents recognised the value of attending ward rounds and generally found it a positive experience, but emphasised limitations on their ability to attend.

Parental beliefs about nocturnal enuresis causes, treatments, and the need to seek professional medical care.

OBJECTIVE: To better understand parental beliefs regarding the etiology and treatment of nocturnal enuresis (NE). METHODS: A self-administered survey queried parental NE beliefs including perceived etiologies and home behavioral treatments. We assessed for associations between demographic characteristics and propensity to seek medical care for NE. RESULTS: Of 216 respondents, 78% were female. The most common causes for NE reported were: deep sleeper (56%), unknown (39%), and laziness (26%). Popular home behavioral therapies included: void prior to sleep (77%) and limiting fluid intake at night (71%). Few reported they would use a bedwetting alarm (6%). Fifty-five percent reported they would seek medical care for NE and 28% reported awareness of effective treatments. On multivariable analysis, females (OR 2.3, 95% CI 1.04-5.0) and those with graduate level education (OR 4.8, 95% CI 1.5-15.7) were more likely to seek medical care for their child with NE. CONCLUSIONS: General parental knowledge of the causes and effective treatments for NE is lacking. Only 55% reported they would seek medical care for their child with NE and only 28% reported awareness of effective treatments. Counseling should focus on dispelling common misconceptions about causes and treatments of NE and focus on proven effective treatments.