균형적 언어교육 프로그램 모형 개발 -드림스타트 저소득 가정 유아를 대상으로-

IN FEBRUARY OF THIS YEAR, THE STATE CHILDREN’S HEALTH Insurance Program (SCHIP) Reauthorization Act of 2009 was officially extended through 2013. SCHIP is a joint insurance program between the federal government and the states, which provides health insurance for low-income children and pregnant women who are not eligible for Medicaid. That is, states provide SCHIP for children in families with incomes up to 200 percent of the federal poverty level ($21,000 to $42,000 for a family of four). SCHIP currently provides health care insurance to approximately 7 million children who otherwise would not receive health care benefits.1 There are an additional 6 million children who are eligible, but not enrolled in either SCHIP or Medicaid.2 As more families face job loss and the associated loss of health insurance, SCHIP is even more important for the health and development of infants and children in low income families.

ABSTRACTThis study aims to determine the predictors of acute diarrhoea among hospitalized children in the Gaza Governorates. The case-control design included 140 children (70 cases and 70 controls) in a stratified cluster sample from Naser Medical Complex and Alnasser Pediatric Hospital. An interview questionnaire was used, and face and content validations were performed. Multiple logistic regression was used for the multivariate analysis of risk factors of diarrhoea in children aged less than five years. Results showed a significant association between diarrhoea and family income, residence, complementary feeding, and age of weaning (p<0.05). Children living in villages had lower odds of having diarrhoea by 53.2% than children living in cities. Children of families with incomes between US$ 485 and 620 had lower odds of having diarrhoea by 80.8% than children of families with incomes less than US$ 485. Moreover, children who did not receive complementary feeding had lower odds of having diarrhoea by 59.0%. We found that, for one month increase in weaning age, the odds of diarrhoea decreased by 1.06 times (adjusted OR=1.05, 95% CI 1.0180-1.100). The study concludes that urban residence, lower family income, complementary feeding, and lower age of weaning are risk factors of diarrhoea among children aged less than five years in the Gaza Strip. The results of the study suggest that children of low-income families and those who were not naturally breastfed may warrant more attention for prevention and/or treatment of diarrhoea.

To examine the association between type of health insurance (public, uninsured, private, or other) and oral health outcomes for children in the United States using nationally representative surveillance data. Using the National Health and Nutrition Examination Survey (2011/12-2013/14), logistic regression models were used to estimate the odds of any dental caries and any untreated caries by type of health insurance (public, uninsured, private, and other) for children aged 2-19 years, with adjustment for relevant individual and socioeconomic characteristics. Among 6,057 children, the odds of having any dental caries or untreated caries was not significantly different for publicly insured and uninsured children compared to privately insured children, when adjusting for family income and education. Children in families with income to poverty ratios <200 percent had greater odds of caries and untreated caries relative to children in families with income to poverty ratios ≥400 percent. Children with less educated parents also experienced greater odds of caries and untreated caries. Oral health outcomes, after adjusting for covariates, were similar for children with public and private health insurance. However, children in low-income families and with less educated parents had greater odds of untreated caries and dental caries, suggesting that initiatives focused on publicly insured populations may miss other vulnerable children of low socioeconomic status.

SummaryBackgroundThere is emerging evidence on the impact of social and environmental determinants of health on paediatric intensive care unit (PICU) admissions and outcomes. We analysed UK paediatric intensive care data to explore disparities in the incidence of admission according to a child's ethnicity and the degree of deprivation and pollution in the child's residential area.MethodsData were extracted on children <16 years admitted to UK PICUs between 1st January 2008 and 31st December 2021 from the Paediatric Intensive Care Audit Network (PICANet) database. Ethnicity was categorised as White, Asian, Black, Mixed or Other. Deprivation was quantified using the ‘children in low-income families’ measure and outdoor air pollution was characterised using mean annual PM2.5 level at local authority level, both divided into population-weighted quintiles. UK population estimates were used to calculate crude incidence of PICU admission. Incidence rate ratios were calculated using Poisson regression models.FindingsThere were 245,099 admissions, of which 60.7% were unplanned. After adjusting for age and sex, Asian and Black children had higher relative incidence of unplanned PICU admission compared to White (IRR 1.29 [95% CI: 1.25–1.33] and 1.50 [95% CI: 1.44–1.56] respectively), but there was no evidence of increased incidence of planned admission. Children living in the most deprived quintile had 1.50 times the incidence of admission in the least deprived quintile (95% CI: 1.46–1.54). There were higher crude admission levels of children living in the most polluted quintile compared to the least (157.8 vs 113.6 admissions per 100,000 child years), but after adjustment for ethnicity, deprivation, age and sex there was no association between pollution and PICU admission (IRR 1.00 [95% CI: 1.00–1.00] per 1 μg/m3 increase).InterpretationEthnicity and deprivation impact the incidence of PICU admission. When restricting to unplanned respiratory admissions and ventilated patients only, increasing pollution level was associated with increased incidence of PICU admission. It is essential to act to reduce these observed disparities, further work is needed to understand mechanisms behind these findings and how they relate to outcomes.FundingThere was no direct funding for this project. HM was funded by an 10.13039/501100000272NIHR Academic Clinical Fellowship (ACF-2022-18-017).

This research focuses on the self-concept in children of low-income families. A questionnaire was given to elementary school-aged children(grades 3-6). 454 children from low-income families were surveyed. The major findings were as follows: first, the variables that affected the self-concept among the low-income families children were relatively different. For boys, the major influential individual variables were in the following order: grade, stress, and the father's affective attitude. For girls, the major influential individual variables were in the following order: stress, support from friend, father's affective attitude, and grade. Second, through this comparison, this study examined the relative influence of variables that affected children's self-concept. This study proposes interventions to improve their self-concept mechanisms.

The present study proposed to examine whether family factors are associated with child meal skipping in Korea. Family factors were divided into risk factors and protective factors on conceptual and theoretical bases. The sample was obtained from the Survey of Meal Service for Poor Children conducted by the Korea Institute for Health and Social Affairs in 2007. A final sample was composed of 944 children in low-income families who are served by the public meal program. Child meal skipping was positively associated with risk factors and negatively associated with protective factors, as hypothesized. Single-father family, middle or small urban area, presence of caretaker after school, health level of caretaker, caretaker's concern about child's diet, and degree of family cohesion significantly predicted child meal skipping. The authors suggest a few implications for practice based on the study findings.

This study investigated low-income mothers' daily nighttime and weekend work and family outcomes. Sixty-one mothers of preschool-aged children reported daily on work hours, mood, mother-child interaction, and child behavior for two weeks (N = 724 person-days). Although nighttime and weekend work are both schedules, results showed adverse associations of working nighttime hours on family outcomes-more negative mood and mother-child interactions; less positive child behavior-but no relationship between weekend work and family outcomes. Key Words: low-income families, parent-child relationships, work and families, working mothers. In the last half century, the number of women participating in the labor force in the United States has increased dramatically, with particular increases among low-income women (Blank, 2002). At the same time, the nature of work in the United States has evolved. Service and sales sectors have expanded, and the economy increasingly operates around the clock, amplifying demand for workers outside the traditional 9-to-5 workday (Presser, 2003). It is now common for individuals to work schedules - in the evening, nights, or on weekends - leading to concerns about the effects of work scheduling on families and children. Nonstandard work is more common among lower-income individuals (Presser), and so children in low-income families are more likely to be affected by their parents' work schedules. Research on the effects of work schedules on both workers and their families has generally found that work schedules have negative effects, particularly in studies of mixed- and higher-income families (Han, 2005, 2006; Han & Waldfogel, 2007; Strazdins, Clements, Korda, Broom, & D'Souza, 2006; Strazdins, Korda, Lim, Broom, & D'Souza, 2004). Studies focused on low-wage workers, however, have produced mixed results (Han, 2008; Hsueh & Yoshikawa, 2007; Joshi & Bogen, 2007; Phillips, 2002), and additional information is still needed about how mothers' work schedules affect low-income families. Prior research has commonly compared parents categorized as working or schedules, on the basis of a typical work week. That design has three limitations: unobserved selection into different schedules may bias results; standard and nonstandard categories may mask withinperson variability in work schedules; and, in most studies, the nonstandard category includes both nights and weekends, although their consequences may differ. This study addressed a number of limitations in the literature on work during schedules. First, it focused on an understudied group, low-wage workers with preschool-age children. Second, it collected daily reports from low-income working mothers over a period of two weeks regarding work schedules, maternal mood, mother-child interaction, and child behavior. Rather than comparing workers who have been grouped into static work schedule categories, the design of this study allowed for the examination of within-family variability in work schedules. Thus, the results presented here more rigorously address the selection problem that has plagued studies of work schedules. Finally, this study considered the effects of different types of schedules - nighttime work and weekend work - separately. NONSTANDARD WORK SCHEDULES IN LOW-INCOME FAMILIES Although researchers' exact definitions of work schedules differ, most agree that work includes evenings, nights, or weekends, and on rotating or irregular shifts (Presser, 2003). Standard schedules are defined as fixed daytime hours, Monday to Friday. Work during schedules is increasingly common. Across income levels, 29% of working mothers worked schedules in 2004 (McMenamin, 2007). That rate is even higher in the services and hospitality industries, which employ high numbers of low- wage workers. …

Learning to read transforms lives. Reading contributes to knowledge acquisition, cultural engagement, and success in the school. The unequal distribution of literacy skills in a society is associated with economic and social inequalities as a result, children with a poor foundation in literacy before entering formal schooling are more likely to struggle academically and to drop out of school. For these reasons, there has been an intense scientific interest for decades in understanding how children learn to read. It is well established that in the early stages of reading development, phonological awareness, letter name-sounds knowledge, and the naming speed are three independent longitudinal predictors of children’s later word-reading skills in alphabetic-writing systems. Phonological awareness constitutes the ability to recognize and manipulate the sounds of their own language, meanwhile letter knowledge promotes the discovery of systematic relationships between writing and oral language. As early readers develop some level of phonological awareness and some level of letter knowledge, they can recognize written words through phonological recoding processes, in which graphemes are recoded as phonemes and assembled to pronounce words. In addition, rapid naming expresses the speed at which phonological information is accessed from a graphic label. Phonological processing and letter knowledge are powerfully affected by the experience, stimulation, and support that children receive before beginning formal education. Most children acquire these abilities relatively effortlessly during early childhood. However, there is a significant number of children in Latin America who experience difficulties in their pre-literacy skills development. This study examined the cognitive profiles of a total of 50 Uruguayan preschoolers from different socioeconomic backgrounds from two public schools in Montevideo, Uruguay. Twenty-six children from low-income households were compared to peers from middle-income. At the end of the pre-schooling period (time 1) receptive vocabulary, phonological awareness, letter name-sounds knowledge, and object naming speed tests were administered to children. One year later (time 2), word -reading of a subgroup of children was measured. Significant correlations were observed between all predictors at time 1; between predictors at time 1 and word reading at time 2; and between all measured abilities and socioeconomic status. Comparative analysis between children of different socioeconomic status showed that children growing up in poverty contexts performed more poorly than their peers from middle-income families in all the tests. Nonetheless, both groups performed poorly in word reading. Descriptive statistics indicated that, out of a total of 26 words, low SES children correctly read a total of 7 words per minute, and medium SES children a total of 14 words. Finally, regression analyses indicated that phonological awareness contributed 30 % variance in predicting the total score achieved in a reading-word test in children of low-income families, meanwhile letter name knowledge contributed 74 % variance in predicting the total score achieved in a reading-word test in their peers from middle-income families. In general terms, results of pre-reading skills and reading performance seem to indicate that children of different socioeconomic status use different word recognition strategies according to their level of letter-knowledge of and phonological processing. Discussion considers international literature pointing out that children who enter elementary school with limited reading-related skills are unlikely to be able to keep pace with their peers. These findings warn about the importance to elaborate systematic and high-quality educational proposals to try to reduce the gap in reading development for children from low-income families. Developing literacy and language skills before formal schooling sets a child up for success in school and life. Results also suggest the importance of analyzing the variables that affect reading development in populations that are not the majority described. https://doi.org/10.16888/interd.2022.39.3.5

Dual language supports for dual language learners? Exploring preschool classroom instructional supports for DLLs' early learning outcomes

Starting Early:Introducing the Issue Jeanne Brooks-Gunn (bio), Lisa Markman-Pithers (bio), and Cecilia Elena Rouse (bio) Across the nation, more and more people want to see children receive quality education before kindergarten. Public opinion polls suggest that 70 percent of adults favor such programs, partly because of the irresistible idea that “starting early,” and ensuring that children arrive in school ready to learn, is the best way to generate happy, healthy, and productive adults.1 The notion of starting early resonates. Head Start, the federally funded prekindergarten program for children from low-income homes, was a cornerstone of President Lyndon Johnson’s War on Poverty. Even then it was believed that students can’t fully benefit from an elementary education if they don’t arrive at kindergarten ready to learn. Presidents with views as disparate as those of George W. Bush and Barack Obama have called for strengthening early childhood education in their budgets and State of the Union addresses. One reason for the strong support of early childhood education is the seemingly compelling evidence that exposing children to educational experiences when they’re young can have profound effects on later educational, social, and adult outcomes. In fact, as Lynn Karoly points out in this issue, estimates based on some older pre-K programs suggest that every dollar invested in prekindergarten pays off $3 to $17 in terms of benefits, both to the adult individual and to society. That suggests prekindergarten is one of the most effective investments that we can make in children. Indeed, James Heckman of the University of Chicago, a Nobel laureate in economics, has argued that investments made in early childhood are more beneficial and also more cost-effective than those made in later childhood and adolescence.2 The idea that prekindergarten can enhance later learning and adult success is based on the premise that if pre-K programs provide enriching activities more intensively and more intentionally than parents can, then those programs have the potential to boost children’s learning and skill acquisition. In brief, quality pre-K experiences can teach [End Page 3] children the skills that make it easier for them to learn new skills in early elementary school: that is, skills beget skills. Differences in literacy and cognitive skills between children in low-income families and their better-off counterparts are already apparent by age three, or perhaps even earlier.3 The pre-K education programs initiated in the 1960s and 1970s were designed to reduce those gaps by providing quality pre-K education to disadvantaged children, who were less likely to be ready for school. Few pre-K programs existed in the low-income neighborhoods where most disadvantaged children lived, and parents with little income and education were therefore less likely to send their children to prekindergarten than were parents with more resources. And when disadvantaged parents were able to find a pre-K program, it was likely to be of relatively low quality.4 Based on these observations, we would expect that children from disadvantaged environments would benefit the most from pre-K education; that high-quality programs would deliver the greatest benefits; and that children who received such education would benefit more than those who remained at home, cared for by parents, family, and friends. Comparisons between different pre-K programs, on the other hand, shouldn’t show such a stark contrast. These assumptions imply that not all programs would show equal benefits in empirical evaluations. Scholars have called this heterogeneity in outcomes. Interpreting the research requires attention to many factors—family background, comparison group composition, and programs’ quality and intensity. Scholars have extensively studied the efficacy of pre-K programs, especially those offered to four-year-olds. Of more than 100 evaluations of pre-K programs, the vast majority used random assignment of children to receive the preschool treatment or not.5 Most of these experimental programs served children from low-resource families, in keeping with the premise that these children were less likely to have the skills needed for kindergarten and were therefore most likely to benefit. Consequently, we know the most about how preschool influences children from disadvantaged backgrounds. And because many of these...

Acute lower respiratory illnesses (ALRI) are the leading cause of death among children <5 years. Studies have found that biomass cooking fuels are an important risk factor for ALRI. However, few studies have evaluated the influence of natural household ventilation indicators on ALRI. The purpose of this study was to assess the association between cooking fuel, natural household ventilation, and ALRI. During October 17, 2004-September 30, 2005, children <5 years living in a low-income neighborhood of Dhaka, Bangladesh, were assessed weekly for ALRI and surveyed quarterly about biomass fuel use, electric fan ownership, and natural household ventilation (windows, ventilation grates, and presence of a gap between the wall and ceiling). Bivariate and multivariate analyses were performed using generalized estimating equations. Six thousand and seventy-nine children <5 years enrolled during the study period (99% participation) experienced 1291 ALRI. In the multivariate model, ≥2 windows [OR = 0.75, 95% CI = (0.58, 0.96)], ventilation grates [OR = 0.80, 95% CI = (0.65, 0.98)], and not owning an electric fan [OR = 1.50, 95% CI = (1.21, 1.88)] were associated with ALRI; gap presence and using biomass fuels were not associated with ALRI. Structural factors that might improve household air circulation and exchange were associated with decreased ALRI risk. Improved natural ventilation might reduce ALRI among children in low-income families. The World Health Organization has stated that controlling pneumonia is a priority for achieving the fourth Millennium Development Goal, which calls for a two-third reduction in mortality of children <5 years old compared to the 1990 baseline. Our study represents an important finding of a modifiable risk factor that might decrease the burden of respiratory illness among children living in Bangladesh and other low-income settings similar to our study site. We found that the existence of at least two windows in the child's sleeping room was associated with a 25% decreased ALRI risk. Increasing available natural ventilation within the household in similar settings has the potential to reduce childhood mortality because of acute lower respiratory illnesses.

This paper presents a social work study on relationship between various family characteristics and street children in rural area as well as city of Esfahan, Iran. The proposed study selects a sample of 150 street children, 75 from city and 75 from rural area, and using some statistical tests verifies the effects of three factors including family income, place of residency and family size on street children. The results indicate that the city residence had more street children than rural residence did. In addition, there was a meaningful difference between the number of street children in low-income families and high-income families. Finally, the survey results indicate that big size families more likely suffered from street children than low size families did.

Comparison of Obesity Rates in Early Childhood (4 to 80 months) by Parental Socioeconomic Status Using National Cohort Dataset in Korea

Persistent unmet preventive and developmental health care needs of children in low-income families are a national concern. Recently, there have been efforts to promote developmental services as part of primary care for all young children. However, there is limited research to determine whether the neediest families are well in universal interventions. In our study, we assessed if disparities persist in utilization of developmental services, well child care, and satisfaction with care among low-, middle-, and high-income families participating in Healthy Steps for Young Children. Healthy Steps is a national experiment that incorporated developmental services into primary care for children from birth to 3 years of age. In the United States, 15 pediatric practices participated in this prospective study. At birth, 2,963 children were enrolled between September 1996 and November 1998 and followed through 33 months of age. The utilization of developmental services, satisfaction with care, and receipt of age-appropriate well child visits were measured at 30-33 months and adjusted for demographic and economic covariates. We found that the adjusted odds of low-income families did not differ from high-income families in receipt of four or more Healthy Steps services, a home visit, or discussing five or more child rearing topics. Low- and middle-income families had reduced adjusted odds of receiving a developmental assessment and books to read. The adjusted odds of low- and middle-income families did not differ from high-income families in being very satisfied with care provided or receiving age-appropriate well child visits. A universal practice-based intervention such as Healthy Steps has the potential to reduce income disparities in the utilization of preventive services, timely well child care, and satisfaction with care.

Background: Early childhood caries is the number one chronic disease affecting young children, and it disproportionately affects children of low income families. Despite recommendations for children to see a dentist by 12 months, many families have trouble accessing oral health care. Caries have many potential consequences, such as pain, impaired chewing and nutrition, infection, increased caries in permanent dentition, school/work absences, difficulty sleeping, poor self-esteem, and extensive, expensive dental work, which often must be completed under general anesthesia. In 2014, the USPSTF recommended …