UNASSIGNED: Autism Spectrum Disorder (ASD) is often associated with deficits in Working Memory Capacity (WMC) and Executive Functions (EFs), as early as the first years of life. Research has shown that, even young children with ASD, WMC and EF deficits can be effectively addressed through interventions employing digital and/or analogical tools. Early intervention is important because executive dysfunction can negatively impact on the quality of life, both of children and their families. However, very few studies have been carried out involving intervention with pre-schoolers with ASD. To fill this gap, we developed an intervention that promotes pre-schoolers\' WMC and EFs by employing both digital apps and analogical playful activities. This study reports on the feasibility of this intervention, which was carried out in a rehabilitative context.
UNASSIGNED: A male pre-schooler diagnosed with ASD was engaged in a total of 17 intervention sessions, all held in a clinical context, over a nine-week period. Outcomes were measured using a battery of pre- and post-treatment tasks focusing on WMC, EFs and receptive language. The clinician who administered the intervention made written observations and noted any improvements in the child\'s performance emerging from the digital and analogical activities.
UNASSIGNED: The pre- and post-test scores for the cognitive tasks revealed qualitative improvements in the following cognitive domains: (a) WMC in the language receptive domain; (b) updating in WMC; (c) inhibition, specifically concerning control of motor response; (d) receptive vocabulary. Furthermore, when monitoring the child\'s performance, the clinician noted improvement in almost all the playful activities. Particularly notable improvements were observed in interaction with the apps, which the child appeared to find very motivating.
UNASSIGNED: This study supports feasibility of a playful digital-analogical intervention conducted by a clinician in a rehabilitation context to promote cognitive abilities in pre-schoolers with ASD. Further studies are needed to establish whether the intervention\'s effectiveness can be generalized to a broad sample of children with ASD.

The researcher investigated how the teachers at the preschool integrated the vision of the preschool, educational goals, and community resources to develop and implement the local culture curriculum as well as what problems they encountered in the process. Thereafter, the researcher developed strategies that can be used to solve such problems. The researcher discovered that the most important aspects of the local culture curriculum were (1) its ability to pique the children\'s interest in history and the humanities through the lens of the children\'s experiences at the market, and (2) its integration of local culture and the community, specifically through interactions between young children and adults at a vegetable market. The implementation of the local culture curriculum involved the following steps: (1) establishing a thematic network; (2) planning the activities, including exploring the children\'s previous experiences and adjusting the curriculum and teaching methods accordingly; (3) conducting the activities, including visiting and participating in work at the market; (4) evaluating the activities; and (5) creating thank you cards and formulating plans for store renovation. Some of the obstacles the teachers encountered in the development and implementation of the vegetable-market-themed local culture curriculum were (1) shortages of preschool teachers willing to teach outdoor courses, (2) concerns about young children\'s safety, and (3) young children\'s lack of experience. Finally, on the basis of my conclusion, the researcher developed the following culturally responsive education strategies: (1) integrating aspects of local culture and the community into courses, (2) situating local culture courses in learning areas, (3) developing local culture curriculum that are rich in humanities, and (4) developing local culture curriculum based on parent-teacher cooperation to overcome teacher shortages at preschools. The results of this study may serve as a reference in the development of a local culture curriculum and other strategies to cultivate young children\'s cultural identities.

Identifying attention-deficit/hyperactivity disorder (ADHD) in pre-schoolers may improve their development if treated, but it is unclear whether ADHD symptoms from this age are stable enough to merit treatment. We aimed to investigate the stability of parent- and teacher-reported ADHD symptoms and ADHD classified above the diagnostic symptom thresholds, including for hyperactivity-impulsivity (HI), inattention and combined presentations from age 3 to 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father and Child Cohort Study. At child age 3 years, parents were interviewed and teachers rated ADHD symptoms. At age 8 years, parents (n = 783) and teachers (n = 335) reported ADHD symptoms by the Child Symptom Inventory-4. We found a significant reduction in the mean number of parent-reported ADHD and HI symptoms from age 3 to 8 years, but otherwise similar mean numbers. Parent-reported ADHD symptoms were moderately correlated between ages, while correlations were low for teachers. A total of 77/108 (71%) of the children classified with parent-reported HI presentation at age 3 years were no longer classified within any ADHD presentation at age 8 years, the only clear trend across time for either informant. There was a low to moderate parent-teacher-agreement in the number of reported symptoms, and very low informant agreement for the classified ADHD presentations. Overall, clinicians should exercise caution in communicating concern about HI symptoms in preschool children. Age 3 years may be too early to apply the ADHD diagnostic symptom criteria, especially if parents and teachers are required to agree.

Families and professionals caring for children with life-limiting conditions face difficult healthcare decisions. Shared decision-making is promoted in many countries, however little is known about factors influencing these processes.
To explore the communication strategies used in shared decision-making for children with life-limiting conditions.
A longitudinal, qualitative, multiple-case study. Cases were centred around the child and parent/carer(s). Most cases also included professionals or extended family members. Data from interviews, observations and medical notes were re-storied for each case into a narrative case summary. These were subject to comparative thematic analysis using NVivo11.
Eleven cases recruited from three tertiary hospitals in England. 23 participants were interviewed (46 interviews). Cases were followed for up to 12 months between December 2015 and January 2017. 72 observations were conducted and the medical notes of nine children reviewed.
Strategies present during shared decision-making were underpinned by moral work. Professionals presented options they believed were in the child\'s best interests, emphasising their preference. Options were often presented in advance of being necessary to prevent harm, therefore professionals permitted delay to treatment. Persuasion was utilised over time when professionals felt the treatment was becoming more urgent and when families felt it would not promote the child\'s psychosocial wellbeing.
Communication strategies in shared decision-making are underpinned by moral work. Professionals should be aware of the models of shared decision-making which include such communication strategies. Open discussions regarding individuals\' moral reasoning may assist the process of shared decision-making.

Good motor skills (MS) and physical activity (PA) are considered important for children\'s physical, social, and psychological development. The Motor skills in PreSchool (MiPS) study-Denmark aimed to optimize children\'s MS through weekly PA sessions. The aim of this paper is to explore the role of local preschool leaders and their strategies in influencing the implementation of MiPS into daily practice. Leaders from all seven preschools in the project were interviewed. The results show that preschool leaders used communication (setting an agenda and dedicating speaking time to address the program at staff meetings) and reflective questioning about the pedagogic staff\'s current practice in relation to the program (adding focus on MS and PA) as their main course of action. Through this form of communication and reflective questioning, the preschool leaders aimed to involve the staff and heighten their sensemaking in the existing practice while also ensuring that the implementation of the program was kept in progress. In sum, future implementation of an MS and PA initiative in preschools should put emphasis on a shared responsibility between leaders and staff combined with an adaptive approach in which the existing practice is reshaped rather than just increasing the workload of the pedagogic staff.

Thyroglossal duct cysts, which are the most frequently encountered congenital cervical anomalies in children, occur due to embryologic remnants of the thyroglossal duct. Although diagnosis may be challenging, clinicians can be aided by imaging and fine-needle aspiration biopsies. We describe the clinical management of a two-year-old boy with a thyroglossal duct cyst mimicking a goitre on a pertechnetate thyroid scan.

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) is an international initiative that offers standardized and validated tools to guide the appraisal of patient-reported outcome measures in healthcare.
To explore the use of a new set of tools from the COSMIN to appraise studies on one outcome measure available to speech and language therapists (SLTs).
We used the COSMIN tools to appraise seven studies and a user manual that reported the measurement properties of the Focus on the Outcomes of Children Under Six (FOCUS), a validated measure of pre-schoolers\' communicative participation that is used in various contexts around the world.
Using COSMIN guidelines, the FOCUS was categorized as a \'category A\' tool because there was a sufficient level of evidence to support its content validity and internal consistency. According to the COSMIN guidelines, this means that the FOCUS can be recommended for use. The quality of evidence supporting measurement properties of the FOCUS received a rating of \'moderate\', meaning users can have moderate confidence in its measurement properties. Since these ratings from the COSMIN tools may be unclear to users of the FOCUS, we have provided more specific recommendations.
The COSMIN tools offer detailed standards to support the appraisal of outcome measures available to SLTs. However, several limitations were observed, and recommendations to support the application of the COSMIN tools are provided. What this paper adds What is already known on the subject Collecting outcome data is essential to ensure speech and language therapy is effective. Until the development of COSMIN there was a lack of standards in the way the measurement properties of outcome measure instruments were appraised. What this paper adds to existing knowledge This paper used the FOCUS, a measure of pre-schoolers\' communicative participation outcomes in speech and language therapy, as a case example to illustrate the applications of the COSMIN tools. In doing so, the strengths and limitations of the current COSMIN tools in appraising the quality of outcome measure instruments are emphasized. What are the potential or actual clinical implications of this work? The COSMIN tools offer a step-by-step, standardized approach to appraise various measurement properties in outcome instruments. Due to existing limitations of the COSMIN tools, appraisal should provide clear and specific recommendations so users of outcome measures (e.g., SLTs, researchers) can identify the appropriate uses of each instrument.

Early language acquisition is critical for lifelong success in language, literacy, and academic studies. There is much to explore about the specific techniques used to foster deaf children\'s language development. The use of rhyme and rhythm in American Sign Language (ASL) remains understudied. This single-subject study compared the effects of rhyming and non-rhyming ASL stories on the engagement behavior and accuracy in recitation of five deaf children between three and six years old in an ASL/English bilingual early childhood classroom. With the application of alternating treatment design with initial baseline, it is the first experimental research of its kind on ASL rhyme and rhythm. Baseline data revealed the lack of rhyme awareness in children and informed the decision to provide intervention as a condition to examine the effects of explicit handshape rhyme awareness instruction on increasing engagement behavior and accuracy in recitation. There were four phases in this study: baseline, handshape rhyme awareness intervention, alternating treatments, and preference. Visual analysis and total mean and mean difference procedures were employed to analyze results. The findings indicate that recitation skills in young deaf children can be supported through interventions utilizing ASL rhyme and rhythm supplemented with ASL phonological awareness activities. A potential case of sign language impairment was identified in a native signer, creating a new line of inquiry in using ASL rhyme, rhythm, and phonological awareness to detect atypical language patterns.

Resonance Raman spectroscopy (RRS) and parent report were used to assess dietary intake of fruit and vegetable (FV) consumption among young children experiencing a nutrition intervention. The nutrition intervention was \"Together, We Inspire Smart Eating\" (WISE). The study followed a convenience sample of low-income children in preschool (N=175) and early elementary (N=199) classrooms over an academic school year. Data were collected in a Southern, rural U.S state. Results of pre- and post-assessments indicated statistically improved consumption of FV at follow-up compared to baseline. Results were consistent using both assessment methods supporting the use of either assessment method.

The accurate assessment of food consumption is crucial in nutritional studies. Since modern nutrition science has become more interested in diet as a whole, studies validating food frequency questionnaires (FFQs) and exploratory dietary patterns are needed. We aimed at examining the relative validity of a 47-item FFQ against three-day food records among three- to six-year-old Finnish children, as well as investigating the consistency of the dietary patterns derived using the principal component analysis (PCA), with food record and FFQ data as inputs. We conducted the PCA without forcing the food record data to match the FFQ items. Altogether, 75% or more of the participants were classified into the same or adjacent quarter of vegetables and fruits as well as sugary food consumption. Furthermore, the intake of folate and vitamin C increased linearly in the quarters of vegetable and fruit consumption, as did the intake of sucrose in quarters of sugary food consumption. Three fairly similar dietary patterns were identified from food records and FFQ data. Concerning the patterns, more than 70% of the participants were classified into the same or adjacent quarter. However, the Spearman correlation coefficients between the respective pattern scores were low (0.25⁻0.33). The FFQ showed acceptable validity when ranking food group consumption compared to food records. Additionally, the FFQ-derived dietary patterns were consistent with those derived using food record data.