A Matched-Pair Analysis of Gross Motor Skills of 3- to 5-Year-Old Children With and Without a Chronic Physical Illness.

PURPOSE: The purpose of this study was to compare the gross motor skills of children with a chronic physical illness with those of their healthy peers. METHODS: Data for children with a chronic physical illness come from the Multimorbidity in Children and Youth Across the Life Course study, and data from children without a physical illness come from the Health Outcomes and Physical Activity in Preschoolers study. Multimorbidity in Children and Youth Across the Life Course and Health Outcomes and Physical Activity in Preschoolers included children ages 3-5 years and administered the Peabody Development Motor Scales-second edition. Participants were sex and age matched (20 male and 15 female pairs; Mage = 54.03 [9.5] mo). RESULTS: Gross motor skills scores were "below average" for 47% of children with a physical illness compared with 9% of children without a physical illness (P = .003). Matched-paired t tests detected significant differences in total gross motor scores (dz = -0.35), locomotor (dz = -0.31), and object control (dz = -0.39) scores, with healthy children exhibiting better motor skills, and no significant difference in stationary scores (dz = -0.19). CONCLUSIONS: This skill gap may increase burden on children with physical illness and future research should assess gross motor skills longitudinally to establish whether the gap widens with age.

Agreement in reporting restrictions in life between children with epilepsy and their parents.

BACKGROUND: This study aimed to determine the parent-child agreement of the Hague Restrictions in Childhood Epilepsy Scale (HARCES) and identify the clinical factors associated with parent-child disagreement and the restrictions. METHODS: Data come from a clinical sample of 90 children ages 9-17 (mean age = 12.9, SD = 6.9, 54% male) attending a pediatric neurology clinic. Parents completed the HARCES, and children completed a modified child-friendly scale (HARCES-M). The parent-child agreement was assessed using intraclass correlation coefficients (ICC) and paired t-tests to compare parent and child responses. Logistic regression examined clinical factors associated with disagreement > 0.5 standard deviation. Associations between clinical factors and restriction scores were examined using linear regression. RESULTS: Parent-child agreement on the HARCES was poor (ICC = 0.36, 95% CI: 0.03, 0.58), and parents reported fewer restrictions in daily activities (t(89) = 2.45, p = .016) and to attend parties (t(89) = 2.12, p = .038); however, the overall restrictions scores were not different (t(89) = 1.55, p = .125). The presence of convulsive seizures (OR = 0.20, 95% CI: 0.05, 0.75) and longer duration of epilepsy (OR = 1.19, 95% CI: 1.01, 1.41) were associated with parent-child disagreement. No clinical factors were significantly related to either the HARCES or HARCES-M scores. CONCLUSIONS: The disagreement in perceptions of restrictions highlights the need to use child-reported measures along with parental reports to comprehensively understand restrictions on children with epilepsy fully. More research is needed to understand what factors explain parent- and child-rated restrictions due to epilepsy.

Family Functioning and Health-Related Quality of Life in Parents of Children with Mental Illness.

Previous research suggests that family dysfunction may be related to lower health-related quality of life (HRQoL) in parent caregivers, but it is unknown if this association exists in the context of child mental illness. Therefore, the objectives of this study were to compare HRQoL between parent caregivers and Canadian population norms using the Short Form 36 Health Survey (SF-36); examine associations between family functioning and parental HRQoL; and investigate whether child and parental factors moderate associations between family functioning and parental HRQoL. Cross-sectional data were collected from children receiving mental healthcare at a pediatric hospital and their parents (n = 97). Sample mean SF-36 scores were compared to Canadian population norms using t-tests and effect sizes were calculated. Multiple regression was used to evaluate associations between family functioning and parental physical and mental HRQoL, adjusting for sociodemographic and clinical covariates. Proposed moderators, including child age, sex, and externalizing disorder, and parental psychological distress, were tested as product-term interactions. Parents had significantly lower physical and mental HRQoL versus Canadian norms in most domains of the SF-36, and in the physical and mental component summary scores. Family functioning was not associated with parental physical HRQoL. However, lower family functioning predicted lower parental mental HRQoL. Tested variables did not moderate associations between family functioning and parental HRQoL. These findings support the uptake of approaches that strive for collaboration among healthcare providers, children, and their families (i.e., family-centered care) in child psychiatry settings. Future research should explore possible mediators and moderators of these associations.

Exploratory examination of the association between physical-mental multimorbidity and physical activity in children.

Children with physical illnesses often experience co-occurring mental illness (known as multimorbidity; MM) and it is currently unknown if MM is associated with physical activity (PA) and if the association differs between internalizing and externalizing disorders. Therefore, the aim of this study was to examine the association between MM and PA. Baseline data from the Multimorbidity in Children and Youth Across the Life Course (MY LIFE) cohort was used. MY LIFE is an ongoing prospective study that follows children ages 2 to 16 years with a chronic physical illness and measures PA using accelerometry and mental illness using the Mini International Neuropsychiatric Interview for Children and Adolescents. 140 children (53.2%) provided valid accelerometer data. Children with internalizing disorders recorded less light (B = -5.87), moderate (B = -1.82), and vigorous PA (B = -1.93) and fewer days meeting PA guidelines [Exp(B) = 0.73] and those with externalizing disorders recorded more light (B = 4.85), moderate (B = 1.78), and vigorous PA (B = 2.41) and more days meeting PA guidelines [Exp(B) = 1.06]. However, only the association between internalizing disorder and days meeting PA guidelines was statistically significant. This study provides preliminary evidence that children with MM may accumulate less PA depending on the type of mental illness they experience.

Psychometric properties and informant agreement of the WHODAS 2.0 in youth with mental disorder.

Objective: This study examined psychometric properties, parent-youth agreement, and factors associated with agreement on the 12-item and 36-item versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Methods: Data come from a clinical sample of 56 youth, aged 14-17 years, receiving mental health care at a pediatric hospital. Correlations between the WHODAS 2.0, KIDSCREEN-27, and demographic variables were used to assess validity. Internal consistency was measured using ordinal alpha. The Bland-Altman method and intraclass correlation coefficients (ICC) were used to assess parent-youth agreement. Logistic regression examined factors associated with disagreement > 0.5 standard deviation. Results: For both parent and youth, correlations were low to moderate in exploring convergent (τ= -0.42 to 0.01) and divergent validity (τ/r = -0.12 to 0.32). Internal consistency was adequate (α > 0.7). Parent WHODAS 2.0 scores were significantly lower than youth scores and Bland-Altman plots revealed poor parent-youth agreement (ICC = -0.04 to 0.33). Lower household income was associated with lower odds of disagreement on the 35-item WHODAS 2.0 (OR= 0.28, 95% CI= 0.08-0.99), and older youth age was associated with lower odds of disagreement on the 12-item WHODAS 2.0 (OR= 0.40, 95% CI= 0.19-0.84). Conclusion: The psychometric properties of both WHODAS 2.0 versions were similar, so the abbreviated version may be sufficient to measure functional impairment in a clinical context. Additional research is needed to better understand the factors that influence discrepancies between informants and the implications for care. However, reports from both youth and parents appear valuable in understanding functional impairment.

Objectif: La présente étude a examiné les propriétés psychométriques, l'entente parent-jeune, et les facteurs associés à l'entente sur les versions en 12 items et en 36 items de la World Health Organization Disability Assessment Schedule (WHODAS) 2.0 (calendrier d'évaluation du handicap de l'OMS). Méthodes: Les données proviennent d'un échantillon clinique de 56 jeunes, de 14 à 17 ans, qui reçoivent des soins de santé mentale dans un hôpital pédiatrique. Les corrélations entre le WHODAS 2.0, KIDSCREEN-27, et les variables démographiques ont servi à évaluer la validité. La cohérence interne était mesurée à l'aide d'alpha ordinal. La méthode Bland-Altman et les coefficients de corrélation interclasse (CIC) ont servi à évaluer l'entente parent-jeune. La régression logistique a examiné les facteurs associés à la mésentente de > 0,5 déviation standard. Résultats: Pour les parents et les jeunes, les corrélations étaient de faibles à modérées en explorant la validité convergente (τ= −0,42 à 0,01) et divergente (τ/r = −0,12 à 0,32). La cohérence interne était adéquate (α > 0,7). Les scores des parents au WHODAS 2.0 étaient significativement plus faibles que les scores des jeunes et les tracés Bland-Altman révélaient une mauvaise entente parent-jeune (CIC = −0,04 à 0,33). Le revenu du ménage plus faible était associé avec des probabilités plus faibles de mésentente au WHODAS 2.0 de 35 items (RC = 0,28, IC à 95 % = 0,08 à 0,99), et l'âge avancé du jeune était associé à des probabilités plus faibles de mésentente au WHODAS 2.0 de 12 items (RC = 0,40, IC à 95 % = 0,19 à 0,84). Conclusion: Les propriétés psychométriques des deux versions du WHODAS 2.0 étaient semblables, donc la version abrégée peut suffire à mesurer la déficience fonctionnelle dans un contexte clinique. Il faut une recherche additionnelle pour mieux comprendre les facteurs qui influencent les divergences entre informateurs et les implications dans les soins. Cependant, les rapports tant des jeunes que des parents semblent valables pour comprendre la déficience fonctionnelle.

Stability of M-ABC-2-measured motor functioning in early childhood: Evidence from a large prospective cohort.

AIM: Some studies have reported that children with poor motor functioning tend to improve over time. However, much existing research does not account for regression towards the mean (RTM). Here, we examine measurement stability among 589 children aged 4-5 years. METHOD: We administered the Movement Assessment Battery for Children 2nd Edition annually to 269 children initially scoring above and 252 at or below the 16th percentile. We measured agreement between year 1 and year 2 standard scores using Pearson correlation and derived expected regression towards the mean (RTM). We then regressed follow-up on baseline scores, controlling for relative age, sex, and exact interval between assessments. Finally, we performed a small illustrative simulation. OUTCOMES AND RESULTS: The mean score in the poor-coordination group rose from 5.6 (SD = 1.5) to 7.2 (SD = 2.8). Year 1 and year 2 scores were correlated at r = 0.66, corresponding to predicted RTM in the MI group of 1.56, close to the observed change of 1.57. Degree of change was not associated with time between assessments. INTERPRETATION: Observed improvements in motor functioning were consistent with measurement error. The stability of motor functioning may be greater than it appears from past research, and reported functional improvements in some studies may be illusory. WHAT THIS PAPER ADDS?

Mental health of siblings of children with physical illness or physical-mental comorbidity.

OBJECTIVES: This study examined the mental health of siblings of children with physical illness (PI), with or without co-occurring mental illness. METHODS: The sample included children aged 2 to 16 years with a chronic PI and their aged-matched healthy siblings (n = 169 dyads). Physical-mental comorbidity (PM) was present if children screened positive for ≥1 mental illness on the Mini International Neuropsychiatric Interview for Children and Adolescents. Parents completed the Strengths and Difficulties Questionnaire (SDQ) to measure child and sibling mental health. RESULTS: Within child-sibling dyads, siblings of children with PI had significantly worse mental health related to conduct problems (d = 0.31), peer problems (d = 0.18) and total difficulties (d = 0.20). Siblings of children with PM had significantly better mental health related to emotional problems (d = 0.42), hyperactivity/inattention (d = 0.23) and total difficulties (d = 0.32). Siblings of children with PI had similar mental health compared with child population norms used in the development of the SDQ. In contrast, siblings of children with PM had significantly worse mental health across all SDQ domains, with the exception of prosocial behaviour. After adjusting for parent psychopathology and family functioning, no statistically significant differences between siblings of children with PM versus siblings of children with PI were found. CONCLUSIONS: Differences in mental health exist between children with PI or PM versus their healthy siblings. However, differences between siblings of children with PI versus siblings of children with PM can be explained by parental and family factors (e.g. marital status, education and income). Findings reinforce family-centred care approaches to address the needs of children with PI or PM and their families.

Effect of cognitively engaging physical activity on executive functions in children.

Purpose: Physical activity (PA) has been shown to enhance executive functions (EFs) in children, and PA involving a cognitive component may confer additional benefit. The purpose of this study was to investigate whether cognitively engaging PA impacts EF, and whether affect and fitness act as either mediators or moderators of this relationship. Methods: A randomized controlled trial was utilized to assess changes in EFs between a 20-min Dual Task (intervention condition), a PA Task (control condition), and a Cognitive Task (control condition). Children were scheduled for two visits in the INfant and Child Health (INCH) Lab at the University of Toronto. Physical fitness was assessed using the 20 m shuttle run, standing long jump, and grip strength tests. EFs were assessed using the Stroop Task, Trail Making Task (TMT), and Forward Working Memory Task (FWMT). Results: 38 children (Mage = 11.95 years, SD = 0.49, 61% female) participated. Repeated measures ANOVA showed main interactions between time on inhibition scores (p < 0.05, η p 2 = 0.489), and positive affect scores (p < 0.01, η p 2 = 0.284). Interaction effects between condition and time were not significant (p = 0.787, η p 2 = 0.014, p = .333, η p 2 = 0.061, p = 0.799, η p 2 = 0.013 for inhibition, switching, and passive working memory, respectively). Results showed no significant mediation effect of affect (95% CI = -0.5915, 2.147), or moderating effect between fitness and EF changes. Conclusion: Possible explanations for these findings include inadequate cognitive engagement, lack of EF transfer, and statistical power. Results suggest any of these interventions may be beneficial for improving inhibition and positive affect in children.

Do subjective and objective measures of stress agree in a clinical sample of youth and their parents?

This study explored agreement and potential relationships among perceived stress (self-reported using the Perceived Stress Scale), hair cortisol concentration (HCC), and mental disorders in a clinical sample of youth and their parents. Data were collected from a cross-sectional sample of 48 youth (38 females; mean age = 15.6 years) with a mental disorder and 72 parents (65 females; mean age = 45.49 years). Agreement was assessed using Bland-Altman plots and intraclass correlation coefficients. Multiple regression was used to model the association between covariates and HCC and perceived stress for youth and parents. Agreement between perceived stress and HCC was low for both youth and parents (ICC = 0.15 to 0.31). Among youth, lower income (ß = 0.24) and parent psychopathology (ß = 0.42) were associated with higher HCC. Female sex (ß = 0.42) and higher parent psychopathology (ß = 0.28) were associated with higher perceived stress, whereas chronic physical illness was associated with lower perceived stress (ß = -0.24). Among parents, female sex (ß = -0.21) was associated with lower HCC and family functioning (ß = 0.46) was associated with higher perceived stress. In youth, higher HCC was associated with generalized anxiety (OR = 1.14) and higher perceived stress was associated with major depressive episode (OR = 1.33), generalized anxiety (OR = 1.10), and separation anxiety (OR = 1.14). Among parents, higher HCC was associated with depression (ß = 0.27) and perceived stress was associated with depression (ß = 0.53) and anxiety (ß = 0.45). This exploratory study shows that agreement between psychological and physiological stress is low in a clinical sample of youth and their parents. Sociodemographic and psychosocial factors, and mental health, are differentially associated with psychological and physiological stress.

Correlates of Moderate-to-Vigorous Physical Activity in Children With Physical Illness and Physical-Mental Multimorbidity.

This study measured physical activity (PA) and explored its correlates among children with multimorbidity (co-occurring chronic physical and mental illness; MM) versus those with chronic physical illness only (PI). This study used baseline data from the Multimorbidity in Children and Youth Across the Life Course (MY LIFE) study, an on-going cohort study following 263 children with a PI 2 to 16 years of age (mean age: 9.8 years, SD = 4.0; 47.7% female). PA was measured using accelerometry, and demographic and psychosocial variables were collected using questionnaires. Of the 55 children with MM and the 85 with PI with valid accelerometer data, 38.1% and 41.2%, respectively, met average daily PA guidelines. Correlates of moderate-to-physical PA (MVPA) among children with MM were age, ρ(53) = -0.45, p = .001, body mass index (BMI), ρ(48) = -0.28, p = .04, self-perceived behavioral conduct, ρ(24) = -0.45, p = .02, physical health-related quality of life, ρ(51) = 0.56, p < .001, and peer support, ρ(52) = 0.27, p = .04. Correlates of MVPA among children with PI were age, ρ(83) = -0.40, p < .001, sex, ρ(83) = -0.26, p = .01, self-perceived social competence, ρ(31) = 0.42, p = .02, self-perceived athletic competence, ρ(31) = 0.48, p = .005, physical health-related quality of life, ρ(83) = 0.34, p = .001, participation in community sport, ρ(31) = 0.41, p = .02, and family functioning, ρ(83) = 0.26, p = .02. These results demonstrate that children with PI and MM are insufficiently active and their PA is correlated with demographic and psychosocial factors.

Evaluated interventions addressing developmental transitions for youth with mental health disorders: a meta-analysis.

PURPOSE: The objective of this meta-analysis was to provide a quantitative synthesis of the effects of studies evaluating developmentally appropriate programs or interventions for transition-age youth with mental health disorders. METHODS: Studies, between January 1992 and March 2021, were included if they contained a sample population with a median age between 12 and 25 years and with a mental health disorder and described the results of health interventions addressing aspects of developmental transitions. Independent reviewers screened study texts and assessed the risk of bias. Random effects meta-analysis was used to pool data on standardized mean differences. RESULTS: Under neurodevelopmental studies (6), the effect size of interventions measuring social outcomes was 1.00 (95% CI: -0.01 to 2.00), parental stress levels was -0.10 (95% CI:-0.74 to 0.55), autism symptoms was -0.40 (95% CI: -1.58 to 0.78), and self-determination was 0.16 (95% CI:-0.38 to 0.70). Under mental illness studies (3), the effect size of interventions measuring adolescent depressive symptoms was 0.48 (95% CI: 0.01 to 0.96) and parental depressive symptoms was 1.09 (95% CI: 0.20 to 1.97). CONCLUSIONS: There is no effect of interventions except on parental depressive symptoms under mental illness studies. Further research with comparable outcomes and assessments is needed.Implications for rehabilitation:Interventions for youth with mental health disorders should be developmentally appropriate and incorporate elements to assist youth in multiple aspects of their lives.The following approaches should be considered in interventions: skills training, prevocational/vocational guidance, a client-centered approach, and/or an ecological/experiential approach.Intervention researchers and practitioners should incorporate similar outcome assessment tools and measures in order to allow for valid comparisons between intervention effectiveness.

Examining the Effects of Acute Cognitively Engaging Physical Activity on Cognition in Children.

Cognitively engaging physical activity (PA) has been suggested to have superior effects on cognition compared to PA with low cognitive demands; however, there have been few studies directly comparing these different types of activities. The aim of this study is to compare the cognitive effects of a combined physically and cognitively engaging bout of PA to a physical or cognitive activity alone in children. Children were randomized in pairs to one of three 20-min conditions: (1) a cognitive sedentary activity; (2) a non-cognitively engaging PA; and a (3) cognitively engaging PA. Executive function (EF) was assessed using a modified Eriksen flanker task immediately before and 10-15 min following the experimental condition. Children ages 6-8 years (n = 48, Mage = 7.04, SD = 1.37; 40% girls) were included in the study. A repeated measures ANOVA found no significant difference between groups with respect to scores on the flanker task. The results do not support the hypotheses that a cognitively engaging bout of PA enhances cognitive performance over non-cognitively engaging PA or sedentary activities. Possible explanations for our findings include overexertion during the acute bout of PA and depletion of positive affect prior to performing the post-intervention EF tasks.

Association between Physical Activity and Fundamental Movement Skills in Preschool-Aged Children: Does Perceived Movement Skill Competence Mediate This Relationship?

OBJECTIVES: The purpose of this research is to examine whether perceived fundamental movement skills (FMS) competence mediated the relationship between actual FMS and physical activity (PA) in Hong Kong preschool-aged children. DESIGN: A cross-sectional study. METHODS: 148 preschool-aged children (43% girls; mean age = 4.52 ± 0.67 years) from five preschools/childcare centres completed all assessments. Actual FMS was rated using the Test of Gross Motor Development-2, whilst perceived FMS was assessed via the Pictorial Scale for Perceived Movement Skill Competence. PA was measured through accelerometry. A bootstrap method was used to assess the potential mediating effect of perceived movement skill competence on the relationship between actual FMS and PA. All mediation models were adjusted for sex and age. RESULTS: Mediation analyses showed that the direct path between actual FMS and moderate-to-vigorous physical activity (MVPA) was significant (b = 0.228, p = 0.008), as was the path between MVPA and actual FMS (b = 0.214, p = 0.008). However, perceived FMS competence did not mediate the association between actual FMS and MVPA in the models. CONCLUSIONS: Our results showed evidence of reciprocal pathways between actual FMS and MVPA, reinforcing the need to simultaneously target both domains as part of broader developmental strategies, initiated in early childhood. Unlike emergent adolescence, perceptions of movement skill competence do not play a significant role in influencing the relationship between actual FMS proficiency and MVPA in this developmental period.

Acute Effects of an Afterschool Running and Reading Program on Executive Functioning in Children: An Exploratory Study.

Objective: Emerging research within school settings suggests acute forms of physical activity and exercise lead to improvements in executive functioning among children. However, research pertaining to these effects within the afterschool setting remains limited. The primary purpose of this study was to investigate the acute effects of a community-based afterschool running and reading program on executive functioning in 8 to 12-year-old children. Method: Fifty participants were initially recruited to participate in this study. However, due to the COVID-19 pandemic, data collection was terminated prematurely which resulted in a sample size of 15 participants. Participants (N = 10) from School 1 completed two batteries of executive function assessments (i.e., inhibition, switching, and updating) separated by 15-min of running or 15-min of sedentary reading. Whereas, only 5 participants from School 2 completed assessments of executive functioning prior to and following the running portion of the program (due to the early termination of data collection). Results: Overall, executive function scores improved across each assessment following the running condition when compared to the reading condition (School 1). Inhibition scores significantly improved, and these effects were very large (School 1). Across both schools, improvements in executive functioning following the running portion of the program ranged from small-large in effect size. Conclusion: Findings from the present study provide initial evidence for the acute effects of a community-based afterschool running and reading program on executive functioning in children. Future research with larger samples in afterschool settings is recommended to replicate this preliminary work.

The Acceptability and Feasibility of a Preschool Intervention Targeting Motor, Social, and Emotional Development.

Background: Children and youth are facing three major challenges: (1) poor mental health, (2) physical inactivity, and (3) lack of school readiness. Fundamental movement skills (FMS) and social-emotional learning (SEL) are two developmental domains that are associated with each of these challenges. Currently, there is little focus on interventions that target both FMS and SEL. Thus, the purposes of this study were to: (1) examine the acceptability and feasibility of an FMS and SEL program (Move 2 Smile) and (2) assess the impact of Move 2 Smile on FMS and SEL in children. Methods: An exploratory, pilot study using a within-subjects design was conducted. Descriptive statistics were computed to assess the acceptability and feasibility of the Move 2 Smile program. Changes in FMS and SEL were analyzed using a paired sample t-test. A focus group was conducted with parents to gain feedback after the program ended. Results: Eleven children (four girls; M age = 50.56 months, SD = 8.63) participated, with families attending 80% of the sessions. The children and parents rated the enjoyment of the program 4.1/5 and 4.7/5, respectively. The instructor rated the children's perceived enjoyment 4.6/5 and feasibility of the sessions 4.7/5. Parents engaged in the FMS take-home activities once per week and the SEL activities three times per week. The intervention had a non-significant small to medium effect on FMS (d z = 0.42, p = 0.19), a significant large effect on social skills (d z = 1.38, p = 0.001) and emotion expressiveness (d z = 0.79, p = 0.03), and a non-significant small to medium effect on emotion knowledge (d z = 0.58, p = 0.10) and emotion regulation (d z = 0.44, p = 0.17). The results from the focus group suggest that parents and children enjoyed the program and that the program was useful and effective at impacting FMS and SEL. Conclusions: This intervention is one of the first to intentionally target both FMS and SEL. Children, parents, and instructors deemed this program as acceptable and feasible. These preliminary findings warrant future evaluations of Move 2 Smile, including a randomized controlled trial.

Self-reported oral health at baseline of the Canadian Longitudinal Study on Aging.

OBJECTIVES: To compare the prevalence of poor self-reported oral health (SROH) and dental service-use in a representative sample of Canadian residents, and to identify associations between SROH and psychosocial determinants of health at baseline of the Canadian Longitudinal Study on Aging. METHODS: Data from baseline interviews from 2010 to 2015 involving 93% of 51 388 adults (n = 47 761) were weighted to compare the prevalence of oral health characteristics adjusted for age, sex, socioeconomics, general health and residence. SROH was assessed as 'excellent', 'very good', 'good', 'fair' or 'poor', and dichotomized as 'fair/poor' and 'good/very good/excellent'. Multivariable logistic regression was used to assess the association of fair/poor oral health with psychosocial determinants of health. RESULTS: Most participants reported 'good/very good/excellent' oral health (92.5%), natural teeth (92.0%) and dental service-use in the previous year (79.6%), yet over 10% had discomfort when eating. Reports of 'fair/poor' oral health were significantly more frequent among participants who had dental concerns, had low socioeconomic status, smoked tobacco or reported poor general health. Dental service-use and tooth loss differed by province. The odds of poor/fair SROH were high (odds ratio ≥1.5) among participants who avoided foods, did not use dental services frequently, had low incomes, smoked tobacco, were depressed, felt unhealthy or had multiple chronic conditions, but by neither sex or age. There were no interprovincial differences. CONCLUSIONS: Most Canadian residents feel in good oral health and use dental services. Oral health inequality is evident between different socioeconomic groups and between healthy and unhealthy people. SROH is strongly associated with socioeconomic and general health status but not with place of residence. However, there were substantial differences in reports of tooth loss and dental service-use across provinces.

A Longitudinal Study of Sport Participation and Perceived Social Competence in Youth.

PURPOSE: Participation in sport presents a unique setting for positive youth psychosocial development. Evidence supporting the relationship between sport and perceived social competence, however, is lacking longitudinal evidence; therefore, it is unknown how the relationship changes through late childhood to early adolescence. The main objective of this study was to evaluate the association between sport participation and self-perceived social competence over 4 years of early adolescence. METHODS: The data for this study are from the longitudinal cohort Physical Health and Activity Study. A total of 2,278 children in grade 4 were followed for 4 years until age 13-14 years. Self-perceived social competence (SPSC) was measured using Harter's Self-Perception Profile for Children. Sport participation was measured using the Participation Questionnaire. Mixed effects models were used to evaluate the effect of sport as a continuous and categorical variable on SPSC. RESULTS: There was a significant association of sport at baseline (b = .06, 95% CI: .04-.08) and a significant association of sport over time (b = .01, 95% CI: 4 × 10-3 to .017) on SPSC for both males and females. When examining sport participation categorically, compared with no sport participation, participation in any category of sport (in-school, out-of-school, or both) is positively associated with SPSC. CONCLUSIONS: The results of this study demonstrated that higher participation in sport is associated with small gains in perceptions of social competence during late childhood to early adolescence, suggesting that sport may be a small yet important contributor to young adolescents' perceptions of their social capabilities.

The Association Between PLAYfun and Physical Activity: A Convergent Validation Study.

Purpose: The purpose of this study was to examine the convergent validity of the PLAYfun tool, a physical literacy-based measure of movement competence, by examining its association with objectively measured physical activity in a sample of children and youth. Method: Participants included 110 children between the ages of seven to 14 years attending a stratified random sample of 27 afterschool programs across the province of Ontario, Canada. The PLAYfun tool was administered to the participants on one occasion at their afterschool program and then they were asked to wear a pedometer for seven consecutive days to measure their physical activity levels. A series of multiple linear regression models were used to examine the association between PLAYfun scores and physical activity, while controlling for age, sex, and time of year (season) in which the data were collected. Results: On its own, the PLAYfun average score accounted for close to 13% of the variance in physical activity, R = .36, R2 = .13, p < .001. The PLAYfun average score was also a significant independent predictor of physical activity, b (SE) = 145.98 (53.46), p < .01, when controlling for age, sex, and season in which the data were collected, R2 = .30, F (4, 105) = 11.04, p < .001. Conclusion: Results from the present study indicate that the PLAYfun tool is a significant predictor of objectively measured physical activity, supporting the convergent validity of the tool.

A systematic review and meta-analysis on the effects of physically active classrooms on educational and enjoyment outcomes in school age children.

OBJECTIVES: Despite the relationship between physical activity (PA) and learning outcomes, the school system has not been able to support the inclusion of PA throughout the day. A solution to this problem integrates PA into the academic classroom. The objective of this review is to determine the impact of active classrooms compared to traditional sedentary classrooms on educational outcomes of school-aged children. DESIGN: We searched ERIC, PubMed, PsychINFO, and Web of Science, reference lists of included studies for randomised controlled studies. Independent reviewers screened the texts of potentially eligible studies and assessed the risk of bias. Data were pooled using random-effects models on standardized mean differences. RESULTS: This review identified 25 studies examining educational outcomes, including approximately 6,181 students. Risk of bias was assessed as either some or high risk of bias for most of the studies and outcomes. Pooled data from 20 studies and 842 participants measuring academic performance shows a small positive effect of active classrooms compared with traditional, sedentary classrooms (SMD = 0.28, 95% CI: 0.09 to 0.47). CONCLUSIONS: Physically active classrooms may slightly improve academic achievement compared to the traditional sedentary lessons. Future research is needed to ensure that studies are adequately powered, employ appropriate methods of randomization, and measure a wide range of important student outcomes across the full spectrum of the school-age.

A Construct Validation Study of PLAYfun.

INTRODUCTION: Physical Literacy Assessment for Youth (PLAYfun) is a measure of motor competence, comprehension, and confidence which is part of a suite of scales used to assess physical literacy in children and youth; however, its measurement properties have not been reported in the published literature. The purpose of this study is to examine the factor structure of PLAYfun, in addition to variations in PLAYfun subscale results by age and sex. METHOD: In this study, we use a sample of children and youth 7 to 14 yr of age (n = 215) to test a proposed factor structure for the motor competence component of PLAYfun and to examine age and sex differences in subscale and total scores. The initial (n = 128) and secondary (n = 98) samples were drawn from a stratified (by geographic region), random sample of 27 after-school programs from a larger pool of 400 programs across the province of Ontario. Seven research assistants were initially trained on the administration of PLAYfun and rated a small pilot sample of 10 children. These trained assessors then assessed the full sample. RESULTS: Interrater agreement was very good (intraclass correlation, 0.87). The hypothesized five-factor structure of the scale was found to have an acceptable fit to the data (root mean square error of approximation, 0.055; 90% confidence interval, 0.03-0.075; comparative fit index, 0.95; Tucker-Lewis Index, 0.94). In general, PLAYfun scores increased with age as developmentally expected. There were few sex differences across skills, but girls did not perform as well as boys on upper and lower body object control skills. CONCLUSIONS: The factor structure and patterns of results by age and sex support PLAYfun as a measure of motor competence. Continued evaluation of the tool and other subscales of PLAY is required.