Associations between outdoor play features and children's behavior and health: A systematic review.

The decline of children's opportunities to play outdoors raises a new concern about the quality of outdoor play environments, and their developmental and well-being benefits for children. This systematic review aims to synthesize the associations between outdoor play features and children's behavior and health. PRISMA guidelines were followed (2021). The inclusion criteria were studies with children aged between 5 and 12 (Population); that addressed presence, absence or disposition of equipment, natural elements, loose parts, resources availability, type of terrain and space modifications (Intervention or Exposure); in pre-post intervention or between groups (Comparison); related to health and behavior in different domains (Outcomes); with an experimental, observational, descriptive or longitudinal design (Study design). Indoor context, adult-led activities and structured activities were excluded. A literature search of five databases (PubMed, Web of Science, ERIC, Scopus, and PsycINFO) was concluded in March 2022. After identifying 28,772 records, duplicates and irrelevant titles were removed, and abstracts and full-text articles were screened in duplicate. The remaining 51 eligible articles (45 primary studies) were assessed for risk of bias with QualSyst. A narrative synthesis of the results was conducted. The most frequent behavioral or health outcome addressed was physical activity. Included studies focused on the following space features: fixed structures, space naturalness, floor markings, loose parts/equipment, area available, and the combination of factors. Although some positive effects were found, the heterogeneity between studies did not allow to draw firm conclusions on the effects of each environmental feature on primary children's health and behavior. Systematic review registration: PROSPERO CRD42020179501.

Child Psychomotricity: Development, Assessment, and Intervention.

Psychomotricity addresses the interactions between psychic functions, motor (and biological) functions, and motor behavior (gestures, posture, attitude, physical activity, and motor skills) [...].

Do My Reactions Outweigh My Actions? The Relation between Reactive and Proactive Aggression with Peer Acceptance in Preschoolers.

Aggressive behaviors negatively impact peer relations starting from an early age. However, not all aggressive acts have the same underlying motivations. Reactive aggression arises as a response to an antecedent behavior of someone else, whereas proactive aggression is initiated by the aggressor and is instrumental. In this study, we aim to understand the relation between reactive and proactive aggression and peer acceptance in preschoolers. Parents of 110 children aged between 3 and 6 years old rated their children's manifestation of reactive and proactive aggressive behaviors. To assess the children's peer acceptance score within their class, they completed a paired comparisons task. The outcomes confirmed that reactive aggression in particular is negatively related to peer acceptance at the preschool age. Our results provide insights for the needs and directions of future research and interventions.

Body-oriented interventions to promote preschoolers' social-emotional competence: a quasi-experimental study.

Introduction: Social-emotional competence is foundational to children's health and well-being. Body-oriented interventions, such as relaxation or play based interventions, have been shown to promote social-emotional competence, however more studies are needed to better understand the specific benefits of each type of body-oriented approach. Objective: The present study aimed to examine the chronic and the acute effects of three body-oriented intervention programs (loose parts play, relaxation and combining loose parts play and relaxation) on preschoolers' social-emotional competence. Methods: A quasi-experimental study was carried out, including 62 preschoolers (4.44 ± 0.93 years) that were allocated into 4 groups: Loose Parts Play program (n = 17); Relaxation program (n = 17); Combined program (n = 13); and Waitlist Control Group (no intervention; n = 15). All three intervention programs had a 12-week duration, with biweekly sessions of 30-min, implemented in the preschool outdoors. To examine the chronic effects of the intervention programs, all instruments (parents' and preschool teacher's questionnaires, tasks and saliva) were collected at baseline and after the 12-week period. To examine the acute effects, saliva samples were collected immediately before and after the 1st and the 24th sessions, with a total of 4 collections per child. Results: Both loose parts play and relaxation interventions significantly improved (p < 0.05) children's positive emotion expression. Several within-groups changes were found for the Loose parts play, Relaxation and Combined programs. Conclusion: Body-oriented interventions effectively promote preschoolers' social-emotional competence.

OUT to IN: a body-oriented intervention program to promote preschoolers' self-regulation and relationship skills in the outdoors.

Introduction: Time for movement and outdoor experiences has decreased in children's daily lives. Nevertheless, a growing body of research has shown that body-oriented interventions and outdoor time benefit preschoolers' social-emotional development, a foundation for mental health. OUT to IN is a body-oriented intervention program implemented outdoors, designed to promote preschoolers' social-emotional competence. This study aimed to evaluate the effects of OUT to IN on preschoolers' self-regulation and relationship skills. Methods: A cluster randomized trial with multi-method and multi-informant assessment was implemented including 233 children between 3 and 6 years (122 boys, Mage = 5.07 years), from 4 preschools (8 groups with OUT to IN intervention, 4 groups without intervention - control group). The 153 children allocated to the OUT to IN group participated in biweekly sessions for 10 weeks. OUT to IN sessions followed a body-oriented approach comprising exercise play, relaxation, and symbolization activities, implemented outdoors by a psychomotor therapist and the preschool teacher. Sessions enabled children to feel, observe and control their bodily states and understand the relationship between their bodies and emotions. Teachers participated in a brief course and on 20 biweekly relaxation sessions. Children's self-regulation was measured through specific tasks and a parent questionnaire. Relationship skills (i.e., empathy, communication, cooperation and sociability) were measured through parents' and preschool teachers' questionnaires. Mann-Whitney test was used to study differences at baseline between the OUT to IN group and the control group, and to study differences in the 10-week changes between both groups. Wilcoxon Test was used for intragroup comparisons. Results: After the 10-week intervention period, children who participated in OUT to IN showed significant improvements on self-regulation and relationship skills (empathy, cooperation and sociability), in comparison to the control group who did not show any significant improvements. Large size effects (η2 > 0.14) were found for most of the variables related to self-regulation and small (η2 > 0.01), medium (η2 > 0.06) and large size effects (η2 > 0.14) were found for the variables related to relationship skills. Conclusion: OUT to IN showed to be an effective body-oriented intervention program in improving children's self-regulation and relationship skills, which are recognized foundations for mental health and well-being.

Feel-Own-Move: a psychomotor therapy program for victims of intimate partner violence living in shelter homes. Feasibility and effects on mental health, bodily dissociation, and quality of life.

Introduction: Intimate partner violence (IPV) is a worldwide concern, impacting victims' mental health, physical health, and quality of life. High rates of posttraumatic stress disorder (PTSD), depression, anxiety, bodily dissociation, and somatic symptoms have been found in victims of IPV, with an important impact on the chronicity of impairments and on the outcomes of psychological interventions. Therapeutic interventions available in shelter homes for victims are scarce in addressing their body-mind needs therefore asking for better empirical research. Thus, the aim of this study was to evaluate the feasibility and effects of Feel-Own-Move (FOM), an 8-week psychomotor therapy program for victims of IPV, on their mental health, levels of bodily dissociation, and general quality of life. Methods: A within-subject repeated measures design was used to evaluate the intervention effects, and feasibility results were analyzed. Results: Seventeen women completed the program (mean age 42.8 years, range 21-64). Results showed a significant decrease in levels of bodily dissociation, with FOM having a large effect size. The intervention also had a large effect size at increasing the environment domain of quality of life, although no statistically significant differences were found. FOM ended with excellent rates of reach, adherence, acceptability, and satisfaction. A positive retention rate was also found. Discussion: In conclusion, FOM seems to be a feasible psychomotor therapy intervention for female victims of IPV living in shelters. Importantly, this program showed to be effective in reducing bodily dissociation among participants, which is suggested to prospectively contribute to their mental health and quality of life.

Relationship between Product and Process Characteristics of Handwriting Skills of Children in the Second Grade of Elementary School.

The purpose of this study was to analyze the relationship between the quality and speed of handwriting and the process characteristics of the handwriting of children in the second grade of elementary school considered as a function of age and gender. A sample of 57 children (mean age 7.25 years, SD 0.43) participated in the study. The Concise Assessment Method for Children's Handwriting (BHK) was used to assess the quality and speed of handwriting. The characteristics of the process of handwriting were assessed using MovAlyzeR® software. The handwriting of boys showed a significantly greater number of strokes and slanted more to the right than the handwriting of girls. Handwriting quality and speed significantly correlated with several process characteristics: the number of strokes, reaction time, duration, relative pen-down duration, average pen pressure, vertical size, horizontal size, road length, and average absolute velocity. This research contributes to the construction of normative values in the process characteristics of the handwriting of elementary school children and provides a promising step towards the early identification of difficulties that can lead to dysgraphia, thus preventing later difficulties in handwriting.

Kindergarten Affordances for Physical Activity and Preschoolers' Motor and Social-Emotional Competence.

This study examined the relationship between the quality of the kindergarten physical and social environment to promote physical activity (PA) and preschoolers' motor and social-emotional competence. Two Portuguese kindergartens (Gondomar city) were selected from a pool of seventeen with an assessment of kindergarten PA best practices (one with high PA practices, the other with low). Thirty-six children (M = 4.42; SD = 1.00 years) without neuromotor disorders participated in this study. Motor and social-emotional competence were assessed with standardized motor skills tasks and parent report of child behaviors. Children from the kindergarten with higher compliance with PA best practices showed significantly better motor competence. No statistically significant differences were found for social-emotional competence scores. These findings emphasize the critical importance of kindergarten in promoting preschoolers' motor competence by assuring a physical and social environment that enhances their PA practice. This is a particularly relevant concern for directors and teachers during the post-pandemic period, given the developmental delays and decreases in physical activity preschool children experienced across the pandemic period.

Which Types of Body-Oriented Interventions Promote Preschoolers' Social-Emotional Competence? A Systematic Review.

There has been a recent increase in body-oriented interventions implemented in educational contexts. Body-oriented interventions are grounded on the body-mind relationship, involving body and movement awareness and expression. In this systematic review of the literature on body-oriented interventions implemented in preschool contexts, we review the scope and quality of the quantitative evidence of each type of body-oriented intervention regarding social-emotional competence. Seven databases were searched for randomized controlled trials (RCTs) and quasi-RCTs. Seven core body-oriented intervention programs were found (e.g., play, relaxation, and psychomotricity). Play programs were the most studied and appear to be the most effective to improve social-emotional competence. Nevertheless, the level of scientific evidence was compromised by the lack of studies with high methodological quality.

Attachment and Depressive Symptoms in Adolescence: The Mediatory Role of Emotion Awareness.

Attachment seems to influence depression through emotion regulation. However, no study has yet examined the mediatory role of emotion awareness, a particular subset of emotion regulation abilities, in the relationship between attachment and depressive problems in early and middle adolescence. The aim of this study is to examine the direct and indirect effects of attachment on depressive symptoms in adolescence, considering the mediatory role of emotion awareness dimensions. A sample of adolescents (n = 223) filled up self-report questionnaires on attachment, emotion awareness and depression. Serial mediation models suggest direct effects on depression: negative for secure attachment and positive for anxious/ambivalent attachment. Anxious/ambivalent attachment has a positive indirect effect through lower differentiation of emotions. Both secure and anxious/ambivalent attachment have indirect positive effects on depression through the sequence of bodily unawareness and differentiation of emotions. Differentiating emotions has a central role in mediating the relationship between attachment and depressive symptoms, and the lack of bodily awareness of emotions contributes to such mediation.

Being Deaf in Mainstream Schools: The Effect of a Hearing Loss in Children's Playground Behaviors.

Naturalistic playground observations are a rich source of information when studying the social interactions of preschool children. On the playground, children can interact with their peers, explore different places and activities, and engage in different types of play. For deaf and hard of hearing (DHH) children, interactions at a playground can be more difficult because of the large number of auditory stimuli surrounding them. Constraints in the access to the social world on the playground might hamper DHH children's interactions with their typically hearing (TH) peers, activities, and play. This pilot study aimed to examine the playground behaviors of preschool DHH children across three aspects: social levels, type of activities, and play choices. For this purpose, 12 preschool DHH children were observed during recess time, and their behaviors were coded and compared to their 85 TH peers. The preliminary findings indicate that DHH children spend less time in social interactions compared to their TH peers and that they still face difficulties when socially engaging with their TH peers. These findings suggest that interventions should focus on three aspects: the physical environment awareness of TH peers about communicating with DHH children, and the use of exercise play to facilitate social interactions between DHH children and their TH peers.

Embodiment-related risk factors for Posttraumatic Stress, Anxiety and Depression in female victims of intimate partner violence.

A central notion in the field of embodiment is that body sensorimotor processes and body mental representations influence emotion, cognition and behavior. By affecting the body, intimate partner violence (IPV) can leave victims with a fragile self, and significant physical and mental health problems. In this study, we aim to examine embodiment-related variables and mental health of female victims of IPV, as well as the impact of embodiment on mental health. A total of 38 female victims of IPV (mean age 40.3 ± 10.9 years) were recruited from shelters and the community. The study assessed the levels of Posttraumatic Stress Disorder (PTSD), Anxiety and Depression, and abilities of Movement Imagery, Interoceptive Accuracy, Interoceptive Sensibility, Body Ownership and Bodily Dissociation. Univariate, bivariate and binary regression analysis were used. PTSD, Anxiety and Depression were highly prevalent among our sample, alongside with altered values of body ownership and interoception. All three mental health disorders were significantly correlated with interoceptive self-regulation, interoceptive trusting, and bodily dissociation. For this group of women, each unit rise in the bodily dissociation scale increased two and six times the risk for developing Depression and Anxiety, respectively. The embodiment of female victims of IPV is altered, and higher bodily dissociation can be a risk factor for the development of mental health problems. Restoration of embodiment-related functions could be important for the victims to overcome the negative effects of violent relationships.

Key factor cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults: the role of physical fitness, body composition, physical activity, health condition, and environmental hazards.

BACKGROUND: Fall risk assessment and determination of older adults' individual risk profiles are crucial elements in fall prevention. As such, it is essential to establish cutoffs and reference values for high and low risk according to key risk factor outcomes. This study main objective was to determine the key physical fitness, body composition, physical activity, health condition and environmental hazard risk outcome cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults. METHODS: Five-hundred community-dwelling Portuguese older adults (72.2 ± 5.4 years) were assessed for falls, physical fitness, body composition, physical (in) activity, number of health conditions and environmental hazards, and sociodemographic characteristics. RESULTS: The established key outcomes and respective cutoffs and reference values used for fall risk stratification were multidimensional balance (low risk: score > 33, moderate risk: score 32-33, high risk: score 30-31, and very high: score < 30); lean body mass (low risk: > 44 kg, moderate risk: 42-44 kg, high risk: 39-41 kg, and very high: < 39 kg); fat body mass (low risk: < 37%, moderate risk: 37-38%, high risk: 39-42%, and very high: > 42%); total physical activity (low risk: > 2800 Met-min/wk., moderate risk: 2300-2800 Met-min/wk., high risk: 1900-2300 Met-min/wk., and very high: < 1900 Met-min/wk); rest period weekdays (low risk: < 4 h/day, moderate risk: 4-4.4 h/day, high risk: 4.5-5 h/day, and very high: > 5 h/day); health conditions (low risk: n < 3, moderate risk: n = 3, high risk: n = 4-5, and very high: n > 5); and environmental hazards (low risk: n < 5, moderate risk: n = 5, high risk: n = 6-8, and very high: n > 8). CONCLUSIONS: Assessment of community-dwelling older adults' fall risk should focus on the above outcomes to establish individual older adults' fall risk profiles. Moreover, the design of fall prevention interventions should manage a person's identified risks and take into account the determined cutoffs and respective interval values for fall risk stratification.

Effects of Body-Oriented Interventions on Preschoolers' Social-Emotional Competence: A Systematic Review.

OBJECTIVE: A growing body of evidence supports the effectiveness of body-oriented interventions (BOI) in educational contexts, showing positive influences on social-emotional competence. Nevertheless, there is a lack of systematization of the evidence regarding preschool years. This is a two-part systematic review. In this first part, we aim to examine the effects of BOI on preschoolers' social-emotional competence outcomes. DATA SOURCES: Searches were conducted in Pubmed, Scopus, PsycInfo, ERIC, Web of Science, Portal Regional da BVS and CINAHL. ELIGIBILITY CRITERIA: English, French and Portuguese language articles published between January 2000 and October 2020, that evaluated the effects of BOI implemented in educational contexts on social-emotional competence of preschool children. Only randomized controlled trials (RCT) or quasi-RCT were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently completed data extraction and risk-of-bias assessment. The level of scientific evidence was measured through the Best Evidence Synthesis. RESULTS: Nineteen studies were included. There was strong evidence that BOI do not improve anger/aggression, delay of gratification and altruism. Nevertheless, there was moderate evidence that BOI effectively improve other social-emotional outcomes, such as empathy, social interaction, social independence, general internalizing behaviors, and general externalizing behaviors. The lack of scientific evidence was compromised by the methodological quality of the studies. CONCLUSION: BOI effectively improve specific social-emotional competences of preschool children. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier CRD42020172248.

Stepping-forward affordance perception test cut-offs: Red-flags to identify community-dwelling older adults at high risk of falling and of recurrent falling.

The stepping-forward affordance perception test (SF-APT) fills an important gap within the screening of falls risk factors by considering the perception of affordances. The test showed to be a valid instrument for community-dwelling older adults falls risk assessment. The present study aimed to distinguish and test the key outcomes of the SF-APT usable for falls risk assessment in community-dwelling older adults to determine the respective cut-offs. This cross-sectional study enrolled 347 participants (73.1 ± 6.2 years; non-fallers: 57.9%; fallers: 42.1%; recurrent-fallers: 17.9%). Falls occurrence and SF-APT outcomes were assessed. Analyses were performed using multivariate binary logistic regression analysis and receiver operating characteristic (ROC). The area under the ROC curve was computed (AUC) for each built model explaining falling or recurrent falling. Results distinguished the Estimated stepping-forward, and Absolute-error in interaction with Error-tendency as the SF-APT key outcomes for falls risk assessment [AUCfalling: 0.665 (CI 95%: 0.608-0.723); AUCfalling recurrently: 0.728 (CI 95%: 0.655-0.797)]. Computed cut-offs' analysis showed that (i) a boundary stepping-forward estimation >58 cm plus an underestimation bias >5 cm (>42nd percentile) avoid older adults to be recurrent-fallers, and (ii) a boundary stepping-forward estimation >62 cm plus an underestimation bias >6 cm (>54th percentile) avoid older adults to be fallers. In conclusion, results suggest that SF-APT is a valuable tool for falls risk assessment in community-dwelling older adults. Interventions targeting the prevention of falls should consider the above key outcomes and the respective cut-offs as alert red-flags.

Differences between two types of dual tasks according to the educational level in older adults.

INTRODUCTION: For dual-task paradigms, the timed up and go (TUG) test along with other cognitive or motor tasks has been used to evaluate and predict the risk of falling in older adults. However, the interference between motor-cognitive tasks can differ by the cognitive task. OBJECTIVE: To evaluate the performance of the TUG test under a single task condition and two dual-task conditions in older adults and to explore the effect of educational level on task performance. METHODS: A total of 418 older adults (328 females) voluntarily participated in this study. The TUG test was administered as a single task and a dual task with one secondary simultaneous task: counting aloud backward from 100 or naming animals. Comparisons were performed to determine the interference caused by each cognitive task on the motor task, and correlation analysis was performed to explore the role of educational level. RESULTS: The animal task led to a poorer TUG performance and a higher dual-task cost than did the counting task. Furthermore, the motor task led to a higher percentage of errors and cognitive stops in the animal task. Educational level plays a significant role in the interaction between tasks. CONCLUSIONS: Between-task interference differs by the type of cognitive task performed and the educational level of the participants. The results of the present study should be considered when dual-task assessments are planned for older adults.

Is the Effect of Body Dissatisfaction on Depressive Symptoms Dependent on Weight Status? A Study with Early-to-Middle Adolescents.

Depression is a recognized mental health problem in adolescence and body dissatisfaction is an important risk factor. The main goal of this study is to examine the relationship between body dissatisfaction and depressive symptoms, and whether it depends on adolescents' weight status, an issue that remains understudied. Two hundred and fourteen adolescents (12-16 years) completed self-report measures of depressive symptoms, body dissatisfaction and weight status (i.e., current body weight and height, to compute body mass index z-scores, BMIz). Hierarchical multiple regression and moderation analyses were conducted, accounting for gender and age effects on depressive symptoms. Body dissatisfaction was found to be a predictor of depressive symptoms for the low and median BMIz adolescents, but not for those with high BMIz. In addition, this interaction of body dissatisfaction and BMIz improved the ability of the regression model to explain depressive symptoms´ variance beyond the effect of gender and age. The high-BMIz adolescents presented higher body dissatisfaction but similar levels of depressive symptoms, compared to the lower BMIz adolescents. These findings suggest the influence of body dissatisfaction in the emergence of depressive symptoms in the first half of adolescence, and the importance of weight status throughout this path.

The effects of a relaxation intervention on nurses' psychological and physiological stress indicators: A pilot study.

The present pilot study was designed to examine the feasibility and the effects of a psychomotor relaxation program on nurses' psychological (burnout symptoms, affective states) and physiological stress indicators (salivary cortisol). Fifteen nurses engaged in an 8-week psychomotor relaxation program (two 20-min sessions per week) and 15 maintained their usual activities. The current study showed that the psychomotor relaxation program was feasible and well tolerated by the participants. Compared to the control group, the relaxation group showed a decrease in their levels of emotional exhaustion, depression and salivary cortisol. In the fifteenth session, salivary cortisol concentrations significantly decreased from pre-session to post-session. These results provide preliminary evidence that relaxation interventions are effective strategies for reducing the usual stress experienced by nurses, and demonstrate that a psychomotor relaxation program might be an important occupational stress-management tool for healthcare professionals.

Dual task performance and history of falls in community-dwelling older adults.

INTRODUCTION: Falls are a common problem for older adults, and the identification of people at high risk of falling is a major challenge to health systems. OBJECTIVE: To evaluate the association between the history of falls and single-task Timed Up and Go Test (single TUG) or dual-task TUG variables. METHODS: Three hundred seventy seven community-dwelling older persons, with ages ranging from 65 and 92 years, participated in this cross-sectional study. Each participant performed two tests: single TUG and dual TUG. The cognitive task for dual TUG consisted of counting backward by one from 100 while performing the test. The number of cognitive errors, cognitive stops and motor stops were recorded. A new variable comprising time, errors and stops in the dual TUG was computed. RESULTS: The number of falls was significantly associated with mean single and dual TUG performance, mean cognitive errors, mean cognitive stops and mean motor stops. The score in the single TUG time was not able to significantly classify participants as fallers or non-fallers in any of the sexes. On the other hand, the variable "dual TUG time spent adding cognitive stops and cognitive errors" achieved the best ability to classify women as fallers or non-fallers, while "dual task cost" and "dual TUG time spent adding cognitive stops" were the best variables to classify men. CONCLUSIONS: Dual TUG including cognitive stops and cognitive errors may be more capable than the single TUG to detect differences and accurately classify fallers and non-fallers in the elderly.

Multidimensional Assessment of Interoceptive Awareness: Psychometric Properties of the Portuguese Version.

Interoceptive awareness involves several mind-body dimensions and can be evaluated by self-report with the Multidimensional Assessment of Interoceptive Awareness (MAIA), which has been translated and validated in several countries and is being used in research and clinical contexts. This study systematically translated the MAIA with six additional items using a focus group and evaluated its psychometric properties in a respondent sample of 204 Portuguese university students (52% females; M = 21.3, SD = 3.9 years). Based on exploratory factor analysis, we refined the tool into a 33-item version and tested it in a separate sample ( n = 286; 63% females; M = 21.3, SD = 4.7 years). We then conducted confirmatory factor analysis and examined test-retest reliability and convergent and discriminant validity. We confirmed an acceptable model fit for this Portuguese version (MAIA-P) with 33 items and seven scales; it showed good construct validity and acceptable temporal reliability, The MAIA-P appears to be valuable for assessing self-reported interoceptive awareness in Portuguese healthy adults.