How do face masks impact communication amongst deaf/HoH people?

Face coverings have been key in reducing the spread of COVID-19. At the same time, they have hindered interpersonal communication, particularly for those who rely on speechreading to aid communication. The available research indicated that deaf/hard of hearing (HoH) people experienced great difficulty communicating with people wearing masks and negative effects on wellbeing. Here we extended these findings by exploring which factors predict deaf/HoH people's communication difficulties, loss of information, and wellbeing. We also explored the factors predicting perceived usefulness of transparent face coverings and alternative ways of communicating. We report the findings from an accessible survey study, released in two written and three signed languages. Responses from 395 deaf/HoH UK and Spanish residents were collected online at a time when masks were mandatory. We investigated whether onset and level of deafness, knowledge of sign language, speechreading fluency, and country of residence predicted communication difficulties, wellbeing, and degree to which transparent face coverings were considered useful. Overall, deaf/HoH people and their relatives used masks most of the time despite greater communication difficulties. Late-onset deaf people were the group that experienced more difficulties in communication, and also reported lower wellbeing. However, both early- and late-onset deaf people reported missing more information and feeling more disconnected from society than HoH people. Finally, signers valued transparent face shields more positively than non-signers. The latter suggests that, while seeing the lips is positive to everyone, signers appreciate seeing the whole facial expression. Importantly, our data also revealed the importance of visual communication other than speechreading to facilitate face-to-face interactions.

Barriers and Facilitators to Leisure Physical Activity in Children: A Qualitative Approach Using the Socio-Ecological Model.

Despite the benefits of engaging in physical activity during their leisure time, children do not meet the recommendations on physical activity. Following the socio-ecological model as a theoretical framework, the aim of this study was to determine the barriers and facilitators that influence physical activity participation in children's leisure time. Data collection was conducted through focus groups and individual drawings in a sample of 98 eight- to eleven-year-olds from six schools in Cuenca (Spain). Following the socio-ecological model, individual characteristics (age and sex), as well as the microsystem (parents and friends), mesosystem (timing and out-of-school schedule) and exosystem (safety and weather) influence physical activity participation. The relationships between these levels of the socio-ecological model reveal that opportunities for leisure physical activity are determined by children's schedules. This schedule is negotiated by the family and is influenced by parents' worries and necessities. This is the main barrier to physical activity participation due to the creation of more restrictive, sedentary schedules, especially for girls. Our results show the elements required to develop successful strategies to increase physical activity opportunities, namely, focusing on giving children the opportunity to choose activities, raising parents' awareness of the importance of physical activity and improving the perceived safety of parks, taking into consideration the gender perspective.

A Spanish Sign Language (LSE) Adaptation of the Communicative Development Inventories.

This article presents the adaptation of the MacArthur Communicative Development Inventory (CDI; Fenson et al., 1993, Guide and technical manual for the MacArthur Communicative Development Inventories. San Diego, CA: Singular Press; Fenson et al. 1994, Variability in early communicative development. Monographs of the Society for Research in Child Development, 59, 1-173) to Spanish Sign Language (LSE). Data were collected from 55 participants (32 boys and 23 girls; 17 deaf signers, 38 hearing signers) who, evaluated by their caregivers every 4 months, presented a total of 170 records. The parents reported the signs that the children could understand or produce between 8 and 36 months. Results suggested that the CDI adapted to LSE is a valid and reliable instrument. Signing children could understand more signs than they produced at this early developmental stage. There were no significant differences between boys and girls, or between deaf and hearing children. The development of LSE is similar to other sign languages, although with a lower production of signs in the early stages, perhaps due to the bilingualism of most of the children of our study.

Cardiorespiratory fitness as a mediator of the relationship between birth weight and cognition in school children.

Objectives: To examine differences in cognition parameters by birth weight categories and to analyze whether the relationships between birth weight and cognitive functions are mediated by cardiorespiratory fitness (CRF) in schoolchildren. Methods: A cross-sectional study using a sample of 664 school children from the MOVI-Kids study. Variables: i) cognitive function measured by the Battery of General and Differential Aptitudes (BADyG); ii) birth weight, reported by parents; and iii) CRF (20-m shuttle run test). ANCOVA models were estimated to assess differences in cognitive function categories across birth weight and CRF categories. Mediation analysis was conducted with Hayes' PROCESS macro. Results: CRF is a full mediator of the association between birth weight with the verbal and numerical factors, and general intelligence; and is a partial mediator when logical reasoning and the spatial factor were the dependent variables. The available data suggest that, in schoolchildren, the influence of birth weight on cognitive function is mediated by CRF. Conclusions: These findings highlight that children with lower birth weight values and lower fitness levels should be target subgroups to improve children's cognition, in which long-life physical activity interventions at early ages are a priority.

Impact of a multicomponent physical activity intervention on cognitive performance: The MOVI-KIDS study.

INTRODUCTION: This study examined the impact of a multicomponent physical activity (PA) intervention (MOVI-KIDS) on improving cognition in schoolchildren. This paper also analyzed the mediator role of motor fitness between MOVI-KIDS and cognition. METHODS: Propensity score analysis of data from a cluster randomized controlled trial (MOVI-KIDS study). This analysis including 240 5-7 years old children from nine schools in the provinces of Cuenca and Ciudad Real, Spain. MOVI-KIDS program consisted of: (a) three weekly after-school sessions of recreational non-competitive PA lasting 60 minutes during one academic year, (b) educational materials for parents and teachers, and (c) school playground modifications. Changes in cognition (logical reasoning, verbal factor, numerical factor, spatial factor, and general intelligence) were measured. A propensity score cross-cluster matching procedure and mediation analysis (Hayes's PROCESS macro) were conducted. RESULTS: All cognitive variables pre-post mean changes were significantly higher (P ≤ 0.05) in children from intervention schools than those from control schools (effect size ranged from 0.33 to 1.48). The effect of the intervention on the spatial factor and general intelligence was partially mediated by motor fitness (indirect effect = 0.92, 95% CI: 0.36; 1.65; and indirect effect = 1.21, 95% CI: 0.06; 2.62, respectively). CONCLUSIONS: This study shows that a one-school-year multicomponent intervention consisting of a recreational non-competitive PA program, educational materials for parents and teachers, and school playground modifications improved the cognition of first-grade children. Further, our results suggest that the effect of the intervention on cognition was mediated by changes in motor fitness.

The Effects of Long-Acting Stimulant and Nonstimulant Medications in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: The aim of this study was to assess the efficacy and safety of stimulant and nonstimulant medications in children and adolescents using as an outcome measure the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), and to examine the effect of medications in different ADHD subtypes (i.e., inattention and hyperactivity/impulsivity). METHODS: MEDLINE, Scopus, EMBASE, EBSCO (E-journal, CINAHL and SportDiscus), PUBMED, and The Cochrane Central Register of Controlled Trials databases were searched. Randomized controlled trials (RCTs) with parallel group or placebo-controlled studies comparing the effect of medications (stimulants or nonstimulants) in children and adolescents with ADHD were included. The main outcomes were the ADHD-RS-IV total score and subtypes (inattention and hyperactivity/impulsivity). Treatment-emergent adverse events (TEAEs) and secondary outcomes such as systolic and diastolic blood pressure, and pulse rate were considered. RESULTS: The search strategy identified 15 RCTs, including a total of 4648 children and/or adolescents diagnosed with ADHD aged 6 to 17 years old. Overall, both stimulant and nonstimulant medications reduce the ADHD-RS-IV score with a standardized mean difference (SMD) of -0.70 (confidence interval [95% CI], -0.85 to -0.55); in subgroup analyses, the SMD was -0.83 (95% CI, -1.11 to -0.54) for stimulant medications and -0.58 (95% CI, -0.69 to -0.46) for nonstimulant medications. Similar results were observed in inattention and hyperactivity/impulsivity subtypes. The placebo group also showed a medium effect SMD of -0.68 (95% CI, -0.82 to -0.54). The most frequent TEAEs for stimulant and nonstimulant medications, respectively, were decreased appetite (28.6% and 14.2%) and somnolence (4.4% and 34.1%). CONCLUSIONS: These results suggest that both stimulant and nonstimulant medications mitigate ADHD symptoms in children and adolescents, although subgroup analyses suggest a greater effectiveness of stimulant medications.

Prevalence of probable Attention-Deficit/Hyperactivity Disorder symptoms: result from a Spanish sample of children.

BACKGROUND: The aims of our study were to: (i) determine the prevalence of children aged 4 to 6 years with probable Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in the Spanish population; and (ii) analyse the association of probable ADHD symptoms with sex, age, type of school, origin (native or foreign) and socio-economic status in these children. METHODS: This cross-sectional study included 1189 children (4 to 6 years-old) from 21 primary schools in 19 towns from the Ciudad Real and Cuenca provinces, Castilla-La Mancha region, Spain. The ADHD Rating Scales IV for parents and teachers was administered to determine the probability of ADHD. The 90th percentile cut-off was used to establish the prevalence of inattention, hyperactivity/impulsivity and combined subtype. RESULTS: The prevalence of children with probable ADHD symptoms was 5.4% (2.6% inattention subtype symptoms, 1.5% hyperactivity/impulsivity subtype symptoms, and 1.3% combined subtype symptoms). Children aged 4 to 5 years showed a higher prevalence of probable ADHD in the inattention subtype symptoms and in total of all subtypes than children aged 6 years, and children with low socio-economic status reported a higher prevalence of probable ADHD symptoms (each subtype and total of all of them) than those with medium and high socio-economic status. CONCLUSIONS: Early diagnosis and an understanding of the predictors of being probable ADHD are needed to direct appropriate identification and intervention efforts. These screening efforts should be especially addressed to vulnerable groups, particularly low socio-economic status families and younger children.

"Football is a boys' game": children's perceptions about barriers for physical activity during recess time.

The aim of the study was to know the factors that influence boys and girls' perceptions for performing physical activity during playground recess from their own perspective. Ninety-eight schoolchildren aged 8-11 years from five schools from Cuenca (Spain) participated in 22 focus groups and carried out 98 drawings following the socioecological model as a theoretical framework. A content analysis of the transcripts from the focus groups and drawings was carried out by three researchers. Results showed that, in spite of boys and girls identified same barriers, there were gender differences in their perceptions. Gender socialization was the key as central category and helped to understand these differences. Boys preferred play football and this sport had a monopoly on the recess space. Weather was a barrier for boys. Girls and boys, who did not play football, were relegated to peripheral areas and lack of materials was a barrier for them. Teachers were a barrier for all children who did not play football. Thus, in order to promote recess physical activity, researchers, teachers and educational policy makers should take into account gender socialization and promote inclusive non-curricular physical activity in schools.

Association of physical activity with cognition, metacognition and academic performance in children and adolescents: a protocol for systematic review and meta-analysis.

INTRODUCTION: Schools provide a relevant context for improving children's and adolescents' physical and mental health by increasing physical activity during school hours and/or beyond. The interest in the relationship between physical activity programmes and cognition during development has recently increased, with evidence suggesting a positive association. We present a protocol of systematic reviews and meta-analysis of intervention studies that, by determining the effects of chronic physical exercise on children's and adolescents' cognitive and metacognitive functions, cognitive life skills, academic behaviours and achievement, aims to ensure procedural objectivity and transparency, and maximise the extraction of relevant information to inform policy development. METHODS: This protocol is guided by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. Databases to be utilised for a thorough selection of the pertinent literature are MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, PsycINFO and ERIC. Selection is proposed to encompass an international and a national publication level, with inclusion of experimental studies written in English or in Spanish, respectively. Also, relevant references included in the selected studies will be considered suitable for review as supplemental sources.We present an integrated approach to the methodological quality assessment of the selected studies, including the Jadad Scale for the assessment of the quality of randomised controlled trials and the Quality Assessment Tool for Quantitative Studies for pre-post studies and non-randomised controlled trials. The pre-post interventions mean differences will be the primary indicator of the intervention outcome. STATISTICAL ANALYSIS: A subgroup analysis is proposed based on cognitive functions and their neural correlates, metacognitive functions and cognitive life skills, academic achievement areas and academic behaviours. TRIAL REGISTRATION NUMBER: PROSPERO CRD42015029913.

Estudio sobre la Educación para la Salud en los centros de Educación Secundaria de Albacete en 2014 / Study of Health Education in Secondary Schools in Albacete in 2014

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Physical activity intervention (Movi-Kids) on improving academic achievement and adiposity in preschoolers with or without attention deficit hyperactivity disorder: study protocol for a randomized controlled trial.

BACKGROUND: The prevention of obesity and improvement of academic achievement in children are concerns of industrialized societies. Obesity has been associated with psychological disorders, including attention deficit hyperactivity disorder, whose prevalence has been estimated at 6.8 % in Spanish children and adolescents. It is known that physical activity is positively related to academic achievement and negatively related to the risk of obesity in children. However, studies to test the effectiveness of physical activity interventions in improving academic achievement in preschool children are scarce and have some weaknesses that threaten their validity. Moreover, very few studies have examined their effectiveness in improving symptoms of attention deficit hyperactivity disorder. This paper outlines a two-year multidimensional preschool intervention (Movi-Kids) aimed at preventing obesity and improving academic achievement in children with or without attention deficit hyperactivity disorder. METHODS/DESIGN: Twenty-one schools from Ciudad Real and Cuenca, Spain, were randomized to intervention and control groups. In the first academic year, children in the third grade of preschool and the first grade of primary school in the intervention group received the Movi-Kids intervention. In the second academic year, schools were crossed over to the other group. The intervention included children, parents and teachers, and the school environment, and consisted of: (i) three hour-long sessions of recreational non-competitive physical activity after school, weekly, (ii) educational materials for parents and teachers addressing sedentary lifestyle risks and (iii) playground modifications to promote physical activity during breaks. Primary outcome measures of this study were academic achievement (intelligence, cognition, memory, attention and perception), assessed by the Battery of General and Differential Aptitudes, and adiposity measures (body mass index, waist circumference, triceps skinfold thickness and body fat percentage). Secondary outcome measures were: attention deficit hyperactivity disorder risk, motor skills, health-related quality of life and sleep quality. These variables will all be measured in both groups at baseline and at the end of the first and second academic years. DISCUSSION: It seems reasonable that an intervention to promote physical activity based on playground games will be useful for simultaneously improving academic achievement and controlling obesity. TRIAL REGISTRATION: ClinicalTrials.gov NCT01971827 .

Self-reports versus parental perceptions of health-related quality of life among deaf children and adolescents.

The aim of this study was to assess the agreement between deaf children's and adolescents' self-ratings of health-related quality of life (HRQoL) and their parents' proxy reports. This observational cross-sectional study included 114 deaf 8- to 18-years-old students and proxy family members. HRQoL was measured using the KIDSCREEN-27 questionnaire, which was adapted to Spanish sign language for children, with a written version for parents. Respondents completed a self-administered paper questionnaire. Parents' and children's mean scores differences were not significant, except for the "Autonomy and Parents" and "Peers and Social Support" dimensions. Children aged 8-11 years scored higher in some domains of QoL compared to those aged 12-18 years. The level of agreement between children/adolescents' and parents/proxies' responses was acceptable, except for the dimension "Autonomy and Parents." Overall, deaf children/adolescents' self-ratings of HRQoL did not differ from their parents' proxy reports; however, differences were found in the dimensions that explored the quality of the interaction of children/adolescents and parents, the perceived level of autonomy, and social relations and support.

Physical fitness, obesity, and academic achievement in schoolchildren.

OBJECTIVE: To examine the association of physical fitness and obesity with academic achievement and the independent association between fitness and academic achievement after controlling for relevant confounders such as age, parental education, and body mass index in school aged children. STUDY DESIGN: Cross-sectional study including 893 schoolchildren, aged 9-11 years, from Cuenca, Spain. Data were collected from September to November 2010. We measured academic achievement (mean of the grades obtained in several core subjects), physical fitness (cardio-respiratory fitness, muscular fitness, and speed/agility), weight, height, and parental education. Multivariate logistic regression models were used to estimate the probability of being in high quartiles for academic achievement after controlling for potential confounders. RESULTS: Overall, academic achievement scores were positively related to fitness levels. Obese boys had lower scores for academic achievement than overweight or normal weight boys. Good cardio-respiratory and speed/agility levels were associated with high academic achievement after controlling for confounders (OR 3.06; 95% CI, 1.35-6.91; P = .007 and OR 4.25; 95% CI, 1.91-9.44; P < .001, respectively). CONCLUSIONS: Academic success is associated with higher fitness levels. Schools should consider strategies to improve fitness as part of their overall strategy for improving academic achievement.

Validity and reliability of the Spanish sign language version of the KIDSCREEN-27 health-related quality of life questionnaire for use in deaf children and adolescents

Objective: The aim of this paper was to test the validity and reliability of a Spanish sign language (SSL) adaptation of KIDSCREEN-27, a health-related quality of life (HRQoL) questionnaire for use in deaf children and adolescents. Methods: We performed an observational cross-sectional study of 114 deaf children and adolescents aged 8 to 18 years old. The Spanish version of the KIDSCREEN-27 was adapted to SSL through the translation-back translation technique. The adapted questionnaire was then administered using a web tool to ensure complete access to study participants. Floor and ceiling effects were calculated. Structural and cultural validity were tested using exploratory and confirmatory factor analysis. Cronbach's a was used to assess internal consistency. The questionnaire was administered for a second time to the entire sample after 2 to 4 weeks (test-retest reliability). Results: In the SSL version of the KIDSCREEN-27, as in the original Spanish scale, five dimensions explained 59% of the variance. None of the participants obtained the minimum or maximum scores on the scale (floor and ceiling effect, respectively). Confirmatory factor analysis showed the goodness-of-fit of the factor solution with five dimensions of the SSL version. The Cronbach's a of both the total scale and of each of the distinct dimensions was above 0.75. The intra-class correlation coefficient of the test-retest scale was considered acceptable in all the dimensions. Conclusions: The reliability and validity of the SSL version of the KIDSCREEN-27 are similar to those of the original Spanish version, providing a new tool for measuring HRQoL in deaf children and adolescents (AU)

Objetivo: Evaluar la validez y la fiabilidad del cuestionario de calidad de vida relacionada con la salud KIDSCREEN-27 traducido a lengua de signos española (LSE) para niños y adolescentes sordos. Método: Estudio observacional transversal en el que participaron 114 niños y adolescentes sordos de 8 a 18 años de edad. Utilizando la técnica traducción-retrotraducción se adaptó la versión española del KIDSCREEN-27 a la LSE, y se diseñó una herramienta web para que el cuestionario fuese totalmente accesible. Se calculó el efecto suelo y el efecto techo. La validez estructural y transcultural se comprobó mediante análisis factorial exploratorio y confirmatorio. Para evaluar la consistencia interna se utilizó el coeficiente a de Cronbach. El 100% de la muestra efectuó un retest al cabo de 2-4 semanas (fiabilidad test-retest). Resultados: En la versión del KIDSCREEN-27 en LSE subyacían cinco dimensiones que explicaban el 59% de la varianza. Ningún participante obtuvo la puntuación mínima o máxima de la escala (efecto suelo y techo, respectivamente). El análisis factorial confirmatorio mostró la bondad de ajuste de la solución factorial con cinco dimensiones de la versión en LSE. El a de Cronbach tanto de la escala total como de cada dimensión fue superior a 0,75. El coeficiente de correlación intraclase del test-retest fue significativo en todas las dimensiones. Conclusiones: La versión adaptada a la LSE del KIDSCREEN-27 presentó coeficientes de fiabilidad y validez similares a los de la versión original en español, permitiendo disponer de un nuevo instrumento para medir la calidad de vida relacionada con la salud en niños y adolescentes sordos (AU)

Validity and reliability of the Spanish sign language version of the KIDSCREEN-27 health-related quality of life questionnaire for use in deaf children and adolescents.

OBJECTIVE: The aim of this paper was to test the validity and reliability of a Spanish sign language (SSL) adaptation of KIDSCREEN-27, a health-related quality of life (HRQoL) questionnaire for use in deaf children and adolescents. METHODS: We performed an observational cross-sectional study of 114 deaf children and adolescents aged 8 to 18 years old. The Spanish version of the KIDSCREEN-27 was adapted to SSL through the translation-back translation technique. The adapted questionnaire was then administered using a web tool to ensure complete access to study participants. Floor and ceiling effects were calculated. Structural and cultural validity were tested using exploratory and confirmatory factor analysis. Cronbach's α was used to assess internal consistency. The questionnaire was administered for a second time to the entire sample after 2 to 4 weeks (test-retest reliability). RESULTS: In the SSL version of the KIDSCREEN-27, as in the original Spanish scale, five dimensions explained 59% of the variance. None of the participants obtained the minimum or maximum scores on the scale (floor and ceiling effect, respectively). Confirmatory factor analysis showed the goodness-of-fit of the factor solution with five dimensions of the SSL version. The Cronbach's α of both the total scale and of each of the distinct dimensions was above 0.75. The intra-class correlation coefficient of the test-retest scale was considered acceptable in all the dimensions. CONCLUSIONS: The reliability and validity of the SSL version of the KIDSCREEN-27 are similar to those of the original Spanish version, providing a new tool for measuring HRQoL in deaf children and adolescents.

Barriers, facilitators and preferences for the physical activity of school children. Rationale and methods of a mixed study.

BACKGROUND: Physical activity interventions in schools environment seem to have shown some effectiveness in the control of the current obesity epidemic in children. However the complexity of behaviors and the diversity of influences related to this problem suggest that we urgently need new lines of insight about how to support comprehensive population strategies of intervention. The aim of this study was to know the perceptions of the children from Cuenca, about their environmental barriers, facilitators and preferences for physical activity. METHODS/DESIGN: We used a mixed-method design by combining two qualitative methods (analysis of individual drawings and focus groups) together with the quantitative measurement of physical activity through accelerometers, in a theoretical sample of 121 children aged 9 and 11 years of schools in the province of Cuenca, Spain. CONCLUSIONS: Mixed-method study is an appropriate strategy to know the perceptions of children about barriers and facilitators for physical activity, using both qualitative methods for a deeply understanding of their points of view, and quantitative methods for triangulate the discourse of participants with empirical data. We consider that this is an innovative approach that could provide knowledges for the development of more effective interventions to prevent childhood overweight.