Early childhood and education centres (ECECs) are key settings in the promotion of healthy levels of outdoor play and napping among young children. This study aimed to examine the associations between environmental factors and preschoolers' outdoor play and napping in ECECs across an international sample. Data from 187 ECECs in 27 countries (22 low- and middle-income countries) that participated in the third pilot phase (January 2021-April 2025) of the SUNRISE International Study were analysed. The director of each ECEC completed a questionnaire which asked if children participating in the SUNRISE Study were unable to participate in outdoor play and nap time due to a range of environmental barriers. Forty-six percent (n = 86) of ECECs reported at least one environmental factor that prevented preschoolers' outdoor play, and 20% (n = 37) reported at least one factor that disrupted naptime. Hot and cold temperatures, rain and other factors were observed as barriers to outdoor play across regions and country income levels. Indoor noise, extreme temperatures, brightness and lack of space were reported as disrupting preschoolers' naptime across regions and country income levels. For rural ECECs, hot temperatures and lack of space were barriers for outdoor play and napping, respectively. Context-specific strategies are required to create climate-resilient outdoor play spaces and more restful napping environments to optimise early childhood development within ECECs.

This study investigated the validity and reliability of the Turkish version of the School Setting Interview (SSI) for children with neurodevelopmental disorders. A cross-sectional psychometric validation design was used with 115 schoolchildren (6-17 years) diagnosed with either specific learning disability (n = 63) or attention deficit hyperactivity disorder (n = 52) in school and clinical settings across Turkey. Students completed the Turkish SSI, and convergent validity was examined via correlations with the School Function Assessment (SFA). As hypothesis-testing construct validity evidence, SSI scores were compared between genders, and reliability was evaluated through Cronbach's alpha and item analysis. The Turkish SSI showed excellent convergent validity, correlating strongly with SFA participation (r = 0.97), performance (r = 0.97) and assistance (r = 0.95) scores. Additionally, no significant gender differences were found (p = 0.17). Internal consistency was high (Cronbach's alpha = 0.96), with every item contributing positively to the scale. The Turkish SSI is a brief, reliable and valid instrument for gauging student-environment fit in children with neurodevelopmental disorders, enabling educators and occupational therapists to identify barriers and design targeted interventions that foster academic participation and success.

ABSTRACT Background Early identification and diagnosis of autism are essential steps in supporting children and families. In rural communities, families can experience significant challenges in accessing an autism diagnosis. Methods We conducted semistructured interviews with four groups of participants: managers ( n = 11), diagnosticians ( n = 7), clinicians ( n = 14) and parents/caregivers ( n = 20) across six regions in Northern Ontario to learn of barriers and facilitators in accessing an autism diagnosis. Two independent coders coded each transcript and used inductive thematic analysis to identify themes across participants and regions. Results Five themes were generated from participants: (1) Gaps in autism knowledge delay early identification for children requiring an autism assessment; (2) complex systems create navigation barriers for families in knowing where to seek help; (3) families with limited access to resources face delays in the early identification process; (4) staffing challenges exacerbate barriers within the autism diagnostic process; and (5) collaboration among health disciplines while using a culturally responsive approach to care facilitates the autism assessment process. Discussion Hopes about the future of accessing an autism diagnosis were shared by families and professionals; although some challenges are fixed (e.g., vast geography), others are amenable to interventions such as building community knowledge and streamlining service navigation.

Early childhood development (ECD) is critical for lifelong outcomes, especially in low- and middle-income countries. The home environment plays a vital role, with high-quality caregiving practices such as reading, storytelling and interactive play strongly linked to developmental outcomes. The family care indicator (FCI) scale, although widely used to assess caregiving quality, may be outdated due to shifts from traditional print materials to digital media in recent years. This study explores how home environment components, especially reading materials and screen usage, affect ECD in rural China and why the FCI may need to be revised in the near future. Data were collected from 581 children aged 6-24 months in rural Zhejiang Province in 2024. Child development outcomes were measured using the Bayley Scales of Infant Development, Third Edition, and the home environment was assessed via the FCI, supplemented by questions on caregiver and child screen use and caregivers' self-efficacy in accessing online parenting resources. Results show that 40% of children exhibited cognitive delays and 42% language delays, whereas 74% of households lacked magazines or newspapers, and nearly half of caregivers never read books at home. Children were exposed to screens for an average of 22 min per day (SD = 45). The FCI reading material subscale was not significantly associated with developmental outcomes, but when caregivers used educational screen content together with their children, it was positively associated with language development (p < 0.05) and cognitive development (p < 0.10). Caregivers' own screen use for parenting knowledge showed no significant association, likely due to low self-efficacy in navigating online resources. Traditional FCI items on books and newspapers have limited predictive value, whereas educationally oriented screen use appears beneficial, suggesting the FCI should be updated to reflect evolving caregiving practices in the digital age.

To assess early adolescents' academic achievement in relation to sleep and how this association may vary across sociodemographic and environmental characteristics. Data on sixth to eighth graders (n = 262) were from the 2009 New York City Child Community Health Survey. Multinomial logistic regression was used to assess associations between sleep duration and academic performance. Effect modification by sociodemographic and environmental variables was tested. While there was no direct association between children's sleep duration and academic achievement, the association between sleep duration and high academic achievement significantly varied by household crowding. This study provides further support for the 9-11 h of sleep recommendations for children ages 6-13 by the National Sleep Foundation (NSF) and points to sufficient sleep as being especially influential for academic achievement in less crowded households.

Currently, the early detection of cerebral palsy (CP) or risk of CP is recommended to enable targeted and specific intervention. The provision of early therapy is a complex practice that places high demands on both parents and therapists. More knowledge about the perceptions of parents and therapists is needed to help the implementation of family-centred early therapy interventions that are based on recent evidence in clinical practice. This scoping review aims to identify the extent of literature and summarize the evidence exploring parents' and therapists' experiences of early occupational and physical therapy for infants with or at risk of CP. The scoping review was conducted in accordance with the JBI methodology for scoping reviews and reported following the PRISMA Extension for Scoping Reviews checklist. The experiences of parents and therapists were categorized using qualitative content analysis. In total, 16 studies published between 2018 and 2024 were included. Parent-reported experiences were included in 15 studies and therapist-reported experiences in three. The content analysis resulted in five categories reflecting perceptions of valued and challenging aspects of early therapy. Four categories concerned parents' perceptions: parental commitment, parent-therapist collaboration, parents as training providers and parental education. One category concerned therapists' perceptions: providing guidance and educating parents. Insight into perceptions of early therapy highlights the importance of professional coordination of intervention, specific training of therapists, managing parents' feelings of uncertainty and balancing parents' engagement in their role as treatment providers and the pressure they may experience from the responsibility this role entails. This finding contributes important knowledge for the successful implementation of family-centred and evidence-based early therapy interventions in clinical practice for infants with or at risk of CP. A limited number of studies exploring therapists' perceptions were identified, which indicates a knowledge gap and a need for further research.

Early childhood is a critical period in which the development of social, emotional and cognitive skills occurs. Mindful-movement interventions, which combine physical activity and mindfulness practices, have promising benefits in adults; however, their effects in children are not well understood. This systematic review and meta-analysis examined the impact of mindful-movement interventions on the social, emotional and cognitive development of children aged 0-10 years. A comprehensive search was conducted across five databases; papers were screened using both machine learning-assisted and manual processes for eligibility. A total of 16 studies met inclusion criteria, with both randomised and nonrandomised controlled trials included in the review and meta-analysis. Extracted data included intervention characteristics and outcomes. A meta-analysis was conducted using robust variance estimation. The pooled effect of mindful-movement interventions on social-emotional outcomes, encompassing 32 effect sizes from 12 studies, was marginally nonsignificant at 0.252 (95% CI = -0.026, 0.529, p = 0.072) and with considerable heterogeneity (I2 of 79%), this suggested sizeable variability across studies in the level of social-emotional impacts. Cognitive outcomes across eight studies yielded a nonsignificant effect size, 0.330 (95% CI = -0.256, 0.970). For all outcomes, there were insufficient data for subgroup meta-analyses. Mindful-movement interventions have demonstrated a suggestive positive effect on social-emotional outcomes in children; however, evidence for cognitive outcomes is less conclusive. High heterogeneity across the studies included in this review suggest a need for more rigorous research. The findings therefore tentatively support the use of mindful-movement practices in early childhood development.

Families with children diagnosed with autism spectrum disorder (ASD) often encounter significant challenges, manifesting in elevated stress levels and compromised physical and mental well-being. This study employed Latent Profile Analysis (LPA) to comprehensively examine family resilience attributes among 328 Chinese parents of children with ASD. Drawing on Walsh's family resilience framework and the Double ABCX stress-adaptation model, the research examined how protective factors (social support, posttraumatic growth) and risk factors (family stressors) distinctively characterize resilience profiles and predict profile membership, alongside sociodemographic correlates. Through rigorous statistical analysis, the following three distinct family resilience profiles emerged: adversity (32.31%; characterized by low resilience), ordinary (46.65%; demonstrating moderate resilience) and growth (21.03%; exhibiting high resilience). Critically, the findings revealed that higher family income, perceived social support and posttraumatic growth were associated with higher family resilience, while family stressors were associated with lower family resilience. These insights underscore the importance of developing targeted, personalized intervention strategies that can effectively enhance familial coping mechanisms and psychological adaptation for families navigating the complex challenges of ASD.

School dropout remains a pressing issue in rural China. Despite an increasing number of studies exploring its antecedents, there is still limited understanding of the protective factors and mechanisms pertaining to rural students' school retention. Drawing on self-determination theory, this study investigates the interrelationships among four dimensions of social support (i.e., caregivers, peers, school and community), satisfaction of basic psychological needs and school dropout intentions among Chinese rural students. Utilizing longitudinal data from a survey conducted in four junior high schools in Central China (N = 2187), this study employed structural equation modelling to test the mediating effect of basic psychological needs satisfaction on the relationship between the four dimensions of social support and dropout intentions. The mediation analysis reveals that the four dimensions of social support are positively correlated with students' satisfaction of basic psychological needs, which in turn is negatively correlated with their intentions to drop out. The mediating effect of basic psychological needs satisfaction was determined. This study highlights the importance of addressing rural students' psychological needs to enhance school retention. It advocates for integrating these needs into curriculum design, fostering supportive classroom environments and implementing comprehensive social support systems.

Identity development plays a crucial role in the rehabilitation of adolescents with mental disorders. Understanding the key factors influencing self-identity during adolescence can enhance rehabilitation strategies, especially in the context of mental health recovery. This study employed a 4-year longitudinal qualitative research design, involving in-depth interviews conducted from 2020 to 2024. The study explored the dynamics of identity development and identified critical factors at different developmental stages. Data analysis utilised constructivist grounded theory and longitudinal comparative analysis. A total of 10 adolescents with mental disorders participated in the study. The results revealed five key factors influencing identity development: (1) struggling with back-to-school adjustment, (2) perceiving stress, (3) strengthening and growing positive social support networks, (4) embracing self-acceptance and adapting to future expectations and (5) building resilience and toughness. Over time, adolescents showed a positive developmental trajectory in self-identity, supporting the previously established notion of the nonlinear nature of identity development. The study emphasises the importance of collaborative efforts between family and school in supporting adolescents' rehabilitation. It advocates for long-term, individualised strategies that adapt to the evolving self-identity needs of adolescents at different developmental stages. The focus should be on cultivating resilience and providing appropriate support to foster a stable and positive sense of self.