Sleep quality relates to language impairment in children with autism spectrum disorder without intellectual disability.

OBJECTIVES: This study aimed to identify sleep quality profiles of children with autism spectrum disorder (ASD), to compare these profiles with those of typically developing (TD) children, and to verify whether there are differences between them in terms of language skills. METHODS: We evaluated the sleep quality and language skills of 47 children with ASD without intellectual disability (ID) and 32 children with TD. Using a hierarchical cluster analysis, we identified two sleep quality ASD profiles (poor and good). We then performed a series of MANCOVAs and ANOVAs to compare the sleep quality and language skills of the two ASD clusters and the TD group. RESULTS: A main group effect (TD, "poor" cluster, and "good" cluster) was found in the total sleep quality and all its dimensions. Significant differences were revealed between the "good" and "poor" clusters in the total structural language score (F1,46 = 10.75, p < 0.001) and three of its subscales (speech: F1,46 = 9.19, p < 0.001; syntax, F1,46 = 8.61, p = 0.001; coherence: F1,46 = 11.36, p < 0.001); the total pragmatic language score (F1,46 = 7.00, p = 0.001) and three of its subscales (inappropriate initiation: F1,46 = 8.02, p = 0.001; use of context: F1,46 = 8.07, p = 0.001; nonverbal communication: F1,46 = 7.35, p = 0.001); and the social relations score (F1,46 = 9.97, p = 0.003). CONCLUSIONS: Sleep quality in children with ASD (especially a subgroup) is worse than in children with TD. There is an association between sleep quality and language skills, both at the pragmatic and structural levels.

Sleep problems in children with autism spectrum disorder and attention-deficit/hyperactivity disorder: A comparative study and effects on communication skills.

Sleep disturbances are highly prevalent among children with neurodevelopmental disorders, like Autism Spectrum Disorder (ASD) and Attention-Deficit/Hiperactivity Disorder (ADHD). The first objective of this study is to examine the differences in sleep problems between a group of children with ASD without intellectual disabilities, a group with ADHD and a typically developing (TD) group. A second objective is aimed at analyzing the effects of sleep problems and symptom severity on their communication skills. Participants were 122 children between 7 and 12 years old distributed in three groups: 32 TD children, 47 children with ASD and 43 children with ADHD, matched on age and intelligence. Parents completed different questionnaires that measured sleep disturbances and communication skills. Findings show significant differences between the clinical groups and the TD group in most types of sleep disorders. Moreover, the group with ADHD showed significantly more sleep breathing disorders and hyperhidrosis in comparison with ASD and TD, as well as more total sleep problems. In contrast to ASD, the predictive power of sleep problems on communication difficulties was greater in the group with ADHD. The results of the mediation analysis indicate that in both groups, sleep problems partially mediate the relationship between symptoms and communication. This investigation highlights the need of considering sleep disorders when assessing communication skills in ASD and ADHD, given its indirect influence in this domain. Understanding the sleep dysfunctions of both conditions and their repercussions is crucial to develop adjusted interventions.

The Italian version of the "tool to measure parental self-efficacy-short form": psychometric properties of the measure and initial validation.

BACKGROUND AND AIM: Parental self-efficacy is recognized as a core element of the transition to parenthood process. It affects parental mental health, as well as children's psychosocial, neurodevelopmental and health outcomes since early infancy. Parents with higher parenting self-efficacy have a higher likelihood of engaging in quality parenting practices that support optimal self-regulation development in children. Our study evaluated the psychometric properties of the Italian TOPSE-Short Form (I-TOPSE-SF) questionnaire. METHODS: 673 Italian mothers (Mage=37.5; SD=5.7) of children aging 0 to 6 years (Mage=3.9; SD=1.7) were involved in this study. RESULTS: Initial results of Confirmatory Factor Analysis highlighted that the fit indices of the hypothesized 6-factor structure of the TOPSE weren't satisfactory. Acceptable internal consistencies for the total score and the six dimensions of the measure were observed. Evidence for convergent and divergent validity were provided. CONCLUSIONS: The I-TOPSE-SF could be a valuable tool to assess parental self-efficacy up to school age, but it is in need of further considerations about its measurement properties.

The Efficacy of Parent Training Interventions with Parents of Children with Developmental Disabilities.

Parenting children with developmental disabilities (DD) can be generally characterized by a considerable psychological burden. The effects on parental and familial psychological well-being and, consequently, on children's developmental outcomes should not be underestimated, especially in early childhood. The current review aims to advance our understanding of the key factors (e.g., formats, sample characteristics, research design) that characterize parent training interventions, and that could be related to their outcomes, to guide researchers and clinical practitioners to develop and provide efficient programs. Studies were identified via an Internet search from three electronic databases, following PRIMSA guidelines. Studies published until November 2021 were taken into account. The initial search yielded a total of 2475 studies. Among them, 101 studies were fully reviewed. Finally, ten of the studies, which met all the inclusion criteria, formed the basis for this review. Participants' characteristics, main features of the interventions (i.e., study design, structure, and contents), outcome variables and treatment efficacy were deeply examined and discussed. Key factors of parent training interventions with parents of children affected by DD are enlightened, to guide researchers and clinicians in the design and implementation of tailored specific programs, aimed to sustain parenting and foster children's developmental outcomes, from early stages of life.

Parents' Perceptions and Experiences with Their Children's Use of Augmentative/Alternative Communication: A Systematic Review and Qualitative Meta-Synthesis.

Augmentative and alternative communication (AAC) consists of any method of communicating that supplements or completely substitutes oral and/or written language when it is impaired. Therefore, it enables children with complex communication needs to develop their full communicative potential. However, despite the many benefits of AAC and its widespread use, several review studies have underscored the problems faced by parents and children who use AAC in their daily lives. The general objective of this systematic review and qualitative meta-synthesis is to provide a complete overview of parents' experiences and perceptions with their children's use of AAC. Specifically, it aimed to identify common themes and subthemes of interest and to analyze the research quality of the selected studies. An exhaustive literature search was carried out using different electronic databases. Nineteen studies were included, involving 297 parents. A thematic synthesis was undertaken. Three main themes and nine subthemes were identified: service support (accessibility, providers and coordination); characteristics of AAC systems (usability and acceptability, features, cost and funding); and integration of AAC in daily life (family, school, social and community). Findings raise a need for more services that support children with complex communication deficits in different contexts, more functional use of AAC systems at school and in real-world situations, as well as service assistance over an extended time period.

Health-related quality of life in Italian children and adolescents with congenital heart diseases.

BACKGROUND: Congenital heart disease (CHD) is the most common congenital anomaly at birth, affecting approximately 1% of live births. In recent decades great medical and surgical advances have significantly increased life expectancy, shifting healthcare professionals' and researchers' interests in patients' Quality of Life (QoL). The main aims of our study were to evaluate generic and condition-specific QoL in a group of Italian children and adolescents with CHD and their parents and examine the level of agreement and directional disagreement between child/adolescent and parents reports on generic and condition-specific QoL. METHODS: A cross-sectional study was designed with CHD children and adolescents and their parents referred to the Cardiology Department of "Bambino Gesù" Children's Hospital. The PedsQL scale was used, including generic (PedsQL 4.0) and cardiac-specific modules (PedsQL 3.0) were administered to patients and caregivers. A Kruskal-Wallis test was used to compare generic and cardiac module scores between patients with different ages, CHD diagnoses, and between patients who underwent surgery interventions and/or are currently taking cardiac medications. RESULTS: 498 families were enrolled in this study. On average, patients reported a good level of generic and condition-specific QoL, as well as their mothers and fathers. Children aged between 5-7 years old reported lower generic and cardiac-specific total QoL levels than children aged 8-12 years and adolescents (13-18 years). With regard to the agreement, patient-parent agreement on condition-specific QoL ranged from 25 to 75% while on generic QoL, it ranged from 19 to 76%. The highest percentage of disagreement between parents and children was found in patients aged 5-7 years old, both for condition-specific and generic QoL rates. CONCLUSIONS: Our study contributed to the growing body of knowledge on QoL in CHD, emphasizing the need for these families to receive support from multidisciplinary standardized care, including psychological consultations and support.

Intervention Programs to Promote the Quality of Caregiver-Child Interactions in Childcare: A Systematic Literature Review.

Sensitive caregiver-child interactions appear fundamental throughout childhood, supporting infants' wellbeing and development not only in a familial context but in professional caregiving as well. The main aim of this review was to examine the existing literature about Early Childhood Education Context (ECEC) intervention studies dedicated to caregiver-child interaction, fostering children's socioemotional developmental pathways. Studies published between January 2007 and July 2021 were identified in four electronic databases following PRIMSA guidelines. The initial search yielded a total of 342 records. Among them, 48 studies were fully reviewed. Finally, 18 of them met all inclusion criteria and formed the basis for this review. Main factors characterizing implemented programs were recorded (e.g., intervention and sample characteristics, dimensions of the teacher-child interaction targeted by the intervention, outcome variables, main results) in order to frame key elements of ECE intervention programs. Our review points to a range of fundamental issues that should consider to enhance ECEC interventions' efficacy, supporting children's socioemotional development and caregiver-child interaction. Reflections and considerations for future research are provided.

Adolescents' School Burnout: A Comparative Study between Italy and Switzerland.

This study aimed to analyze and compare students' school burnout levels in Switzerland and Italy. Previous research has confirmed that female and older students in particular are highly exposed to burnout risk. Nevertheless, few studies have observed this phenomenon through a cross-national comparison. Data on burnout were collected from a sample of 840 adolescents (Italian students = 497; Swiss students = 343) (Mage = 14.98; SD = 1.06; Female = 50%). Burnout was measured using the School Burnout Inventory, and cross-cultural measurement invariance was tested. The results showed that this burnout measure was equivalent between the Italian and Swiss samples. A multivariate analysis of variance was next conducted to investigate the effects of age, gender, and nationality. Results partially confirmed our hypotheses, showing the effect of age but not of gender in explaining burnout differences among students, and between and within-group variance. In particular, the burnout risk was found to be higher in late adolescence (age 16 to 18, Mexhaution = 2.73; Mcynicism = 2.99; MInadequacy = 3.14) than in mid-adolescence (age 13 to 15 Mexhaution = 2.95; Mcynicism = 3.43; MInadequacy = 3.54). Furthermore, Italian adolescents were more exhausted and cynical (Mexhaution = 2.99; Mcynicism = 3.26) than their Swiss peers (Mexhaution = 2.52; Mcynicism = 2.93) when controlling for age and gender. Findings suggest further investigation of the role played by educational and cultural values may be warranted.

Parental Involvement in Children's Sleep Care and Nocturnal Awakenings in Infants and Toddlers.

BACKGROUND: Sleep regulation and consolidation represent critical developmental processes that occur in the first years of life. Recent studies have highlighted the contribution of caregivers to sleep development. However, the majority of them have primarily focused on maternal behaviors, overlooking fathers. The main goal of the present study was to investigate the associations between paternal and maternal involvement in children's sleep care and the number of night awakenings reported by both parents in infants and toddlers. METHODS: One-hundred-and-one families of infants aged 8 to 12 months and 54 families of toddlers aged 18 to 36 months filled out the following self-report questionnaires: The Brief Infant Sleep Questionnaire and an ad hoc questionnaire to assess parental involvement in sleep care for children. A moderate actor-partner interdependence (APIM) with path analysis was performed to test the predictive role of parental involvement on the children's sleep (no. of nocturnal awakenings) and the moderation role of age on these relationships. RESULTS: Paternal involvement in children's sleep care was associated with the number of night awakenings reported by both parents. Moreover, a significant interaction effect emerged between the children's age and paternal involvement in children's sleep care for predicting nocturnal awakenings. CONCLUSIONS: The main outcomes of this study point to the protective role of paternal involvement in children's sleep during the first years of life.

Exploring the Impact of Augmented Reality in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review.

Autistic Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by persistent difficulties in communication and social interaction along with a restriction in interests and the presence of repetitive behaviors. The development and use of augmented reality technology for autism has increased in recent years. However, little is known about the impact of these virtual reality technologies on clinical health symptoms. The aim of this systematic review was to investigate the impact of augmented reality through social, cognitive, and behavioral domains in children and adolescents with autism. This study is the first contribution that has carried out an evidence-based systematic review including relevant science databases about the effectiveness of augmented reality-based intervention in ASD. The initial search identified a total of 387 records. After the exclusion of papers that are not research studies and are duplicated articles and after screening the abstract and full text, 20 articles were selected for analysis. The studies examined suggest promising findings about the effectiveness of augmented reality-based treatments for the promotion, support, and protection of health and wellbeing in children and adolescents with autism. Finally, possible directions for future work are discussed.

The Interplay of Compassion, Subjective Happiness and Proactive Strategies on Kindergarten Teachers' Work Engagement and Perceived Working Environment Fit.

BACKGROUND: The current cross-sectional study examines a model that was designed to advance understanding of the interplay between compassion towards teachers expressed by teaching colleagues, subjective happiness, proactive strategies and kindergarten teachers' levels of work engagement, and perceived working environment fit. METHODS: The research was conducted with a sample of 319 full-time in-service kindergarten teachers at Italian public preschools-a context in which a few previous studies have been carried out. Self-report questionnaires were administered: The Subjective Happiness Scale, the Santa Clara Brief Compassion Scale, the Utrecht Work Engagement Scale, the Proactive Strategy Scale, and the Teacher-working environment fit scale. Data were analyzed by using the structural equation modelling (SEM) approach. RESULTS: Results show that compassion and subjective happiness have a direct positive total effect on work engagement, whereas the effects of compassion and subjective happiness on experienced working environment fit suggest that the association among constructs is mediated by the role of proactive strategies. CONCLUSIONS: Based on these findings, we strongly advocate that educational policy makers and head teachers' pay close attention to the areas of personal and collective resources and work-related well-being, with a view to effectively address the promotion of early childhood teachers' work engagement and working environment fit.

Predictive Factors of Toddlers' Sleep and Parental Stress.

BACKGROUND: Although most infants consolidate their sleep habits during the first year of life, for many children, sleep is described as disrupted during toddlerhood. Along with individual child variables such as temperamental characteristics, parenting behaviors play a key role in determining children's sleep-wake patterns. The aims of the current study were to evaluate the relationship among toddlers' sleep quality, emotion regulation, bedtime routines, parental bedtime involvement, parental perceived social support and stress, and to integrate a novel combination of the aforementioned dimensions into predictive models of toddlers' sleep quality and parental stress. METHODS: One hundred and sixty parents with 2-3-year-old children filled out the following self-report questionnaires: the Parent-Child Sleep Interaction Scale; the Emotion Regulation Checklist; the Social Provisions Scale; and an ad-hoc questionnaire to assess parental involvement in everyday and bedtime care for children. Three multiple regression analyses were conducted by regressing maternal and paternal parenting stress and infant's quality sleep onto the independent variables described above. RESULTS: Toddlers' emotion regulation and parental psychosocial functioning were related to parental stress. Toddlers' night awakenings and the time required by toddlers to fall asleep were related to parental distress. CONCLUSIONS: The findings evidenced the bidirectional associations among the studied variables, highlighting the protective role of social support in reducing parenting stress and of paternal bedtime involvement in improving toddlers' sleep quality.

Fathers and Sleep: A Systematic Literature Review of Bidirectional Links Between Paternal Factors and Children's Sleep in the First Three Years of Life.

OBJECTIVE: During childhood, sleep problems are a common concern for parents and families. The literature on children's sleep documents a strong association between parental factors and infant sleep quality. However, most studies have only examined maternal attitudes and behaviors. To systematically identify and assess the existing literature on the role of fathers in children's sleep over the first three years of life. METHOD: Studies were identified from January 1993 to July 2020 in four electronic databases, following PRIMSA guidelines. RESULTS: The initial search yielded a total of 657 records. Fifty-nine studies were full review, and 26 studies met all inclusion criteria and formed the basis for the review. Studies were divided into thematic groups as a function of the paternal variables they investigated: Extrinsic Parenting factors, Parent-child Interaction Context, and Distal Environmental Influences. CONCLUSIONS: This review points up a range of paternal variables that can represent risk or protective factors for child sleep. Our results may help parents and healthcare practitioners to identify evidence-based knowledge about sleep. Furthermore, identifying paternal factors that contribute to sleep problems can usefully inform the design of individualized interventions.

Parental Mental Health, Fathers' Involvement and Bedtime Resistance in Infants.

BACKGROUND: Around the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants' factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers' involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives. METHODS: Sixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants' bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted. RESULTS: With regard to infants' bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (ß = -.35, p = .030) and paternal involvement at bedtime (ß = -.45, p = .007). Instead infants' bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (ß = .24, p = .04), infant involvement in constant bedtime routines (ß = -.31, p = .01) and bedtime paternal involvement (ß = -.27, p = .05). CONCLUSIONS: The main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants' bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children's sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children's developing sleep patterns.

Subjective Happiness and Compassion Are Enough to Increase Teachers' Work Engagement?

The present quantitative multi-trait cross-sectional study aims to gain a better understanding of the network of relationship between subjective happiness, compassion, levels of work engagement, and proactive strategies (self- and co-regulation) in a sample of teachers. Participants were 187 full-time in-service teachers (89% female; age M = 48.5; SD = 7.88) from Rome, Italy. We hypothesized that subjective happiness and compassion of early childhood teachers would be related with work engagement in such a way that subjective happiness would promote the engagement of teachers. In a similar fashion, we theorized that subjective happiness would be positively related to self- and co-regulation strategies and that proactive strategies would be in turn associated to work engagement. As expected, the results revealed that subjective happiness and compassion showed effects on work engagement and that this association among constructs was mediated by the role of proactive strategies (ß = 0.22, p < 0.001; ß = 0.37, p < 0.001, respectively). Proactive strategies also have a significant direct effect on work engagement (ß = 0.56, p < 0.001). The study's findings suggest the importance of investing in the quality of the working environment.

Effect of Teachers' Happiness on Teachers' Health. The Mediating Role of Happiness at Work.

The present study aims to expand the understanding of the effects of dispositional happiness and self-esteem, as dispositional traits, on the health of teachers, as well as to understand the role played by the working environment in generating positive affection, thus mediating between the dispositional traits and teachers' health. Two hundred and eighty-two full-time in-service teachers (93.6% female) from Rome (Italy) took part in this study. Their ages ranged from 26 to 55 (M = 40.49 years, SD = 5.93). Participants' teaching experience ranged from 1 to 31 years (M = 9.95 years, SD = 5.65). 30.6% of participants taught in kindergarten (for children aged 0-5 years), 42.6% in primary schools (for children aged 6-11 years), 15.8% in middle schools and 10.9% in high schools. A questionnaire was administered, containing: the Subjective Happiness Scale (SHS); the Rosenberg Self-Esteem Scale (RSES); The adapted version for teachers of the School Children Happiness Inventory (Ivens, 2007); the Physical and Mental Health Scales (SF12). The data were analyzed using the MPLUS software, version 8. Our results showed that teacher happiness at work partially mediates the relationship between dispositional happiness and teacher health, and fully mediates the relationship between self-esteem and teacher health. To the best of our knowledge, the mediational role of teacher happiness has not been addressed before, concerning these dimensions. At the same time, our findings confirmed the role of self-esteem in endorsing health-related behaviors, thus promoting physical and mental health. Moreover, according to our study findings, when teachers acknowledge their workplace as a context in which they feel happy, the impact of dispositional happiness and self-esteem on health conditions is higher. Effective measures to promote teachers' well-being are discussed.

Teachers' Burnout: The Role of Trait Emotional Intelligence and Social Support.

The current study investigates the relations among teachers' trait emotional intelligence, internal and external social support, and their levels of burnout. We hypothesized that both emotional intelligence and teachers' perceived social support were associated with low level of teachers' burnout. We further expected that internal and external support mediated the relationship between trait emotional intelligence and burnout scores. Participants were 318 in-service Italian teachers. The structural equation modeling analysis supports the idea that teachers' trait emotional intelligence is strongly and directly associated with their burnout. Furthermore, internal social support (from the teachers' workplace relationships) was more effective on burnout than support forthcoming from their external context. On the contrary, the mediation hypothesis was partially supported by the empirical data. These findings shed light on the relationship between teachers' emotional competence and their burnout experience at school.

A Cross-National Comparison on Subjective Well-Being of Kindergarten Teachers: Hong Kong and Italy.

Background: Teachers' subjective well-being (SWB) has received much attention, in the light of the major increase in sick leave as well as job quitting among teachers across different cultures and countries. Studies on SWB of kindergarten teachers are still scarce, since most of the academic literature is focused on teachers of primary and secondary schools. Aims: The purpose of this study was to analyze and compare kindergarten teachers' SWB in Hong Kong and Italy. Methods: 367 Hong Kong and 243 Italian kindergarten teachers completed a self-report questionnaire containing: the Job Satisfaction Survey (JSS), the Rosenberg Self-Esteem Scale (RSES), and the General Health Questionnaires-12 (GHQ-12). The questionnaire collected also socio-demographics data. Results: Hierarchical regression analysis showed that country belonging plays the strongest predictive role on self-esteem and mental health. Moreover, the independent t-test showed higher levels of job satisfaction among Italian teachers, while Hong Kong teachers were more satisfied in pay and promotion, but less in supervision, operating condition, co-worker relationship, nature of work, and communication. Conclusion: Results are interpreted in the light of the differences between the two contexts considered, in terms of cultural values and educational systems.

Children's Mathematics and Verbal Self-concepts and Externalizing Behaviors: The Moderating Role of Peer Rejection at School.

Previous research has found a strong correlation between children's academic self-concept and their behavioral problems. The present study examined whether children's peer rejection moderated the relationship between children's math and verbal self-concepts and their behavioral problems at school. We expected that children's social competence, as measured by peer rejection, moderated the negative effect of low self-concept on children's externalizing behaviors. Participants were 173 children (males = 93, Mage = 10.31 years, SD = 1.43). The main findings showed that peer rejection moderated the effect of both low verbal and math self-concepts on children's externalizing behavior. The results are discussed in terms of the protective factor played by children's social competence reducing the impact of low self-concept on children's externalizing behaviors.