School of Social Sciences, Humanities, and Arts

Parent-child dyads in which the child is deaf but the parent is hearing present a unique opportunity to examine parents’ use of non-auditory cues, particularly vision and touch, to establish communicative intent. This study examines the multimodal communication patterns of hearing parents during a free play task with their hearing (N=9) or deaf (N=9) children. Specifically, we coded parents’ use of multimodal cues in the service of establishing joint attention with their children. Dyad types were compared for overall use of multimodal – auditory, visual, and tactile – attention-establishing cues, and for the overall number of successful and failed bids by a parent for a child’s attention. The relationship between multimodal behaviors on the part of the parent were tracked for whether they resulted in successful or failed initiation of joint attention. We focus our interpretation of the results on how hearing parents differentially accommodate their hearing and deaf children to engage them in joint attention. Findings can inform the development of recommendations for hearing parents of deaf children who are candidates for cochlear implantation regarding communication strategies to use prior to a child’s implantation. Moreover, these findings expand our understanding of how joint attention is established between parents and their preverbal children, regardless of children’s hearing status.

China has undergone rapid economic changes in recent years, yet little is known about how children in China understand the social status hierarchies around them. The present study addressed this gap by examining whether Chinese children held essentialist beliefs about two social status categories: residency, an important but understudied status-related category in China, and socioeconomic status (SES). We also examined whether children's beliefs about these categories varied with their age or their own social status background (residency, subjective SES). Chinese 5- to 9-year-old children (47 female) who held residency in a prestigious megacity (N = 50) or less prestigious non-megacities (N = 50) completed two tasks that measured whether they viewed residency and SES as biologically based or causally informative, two dimensions of essentialism. Results suggested that children viewed residency but not SES as biologically based, though this decreased with age. Children from megacities with higher subjective SES were more likely to view residency as causally informative with age, suggesting children with higher social status are more likely to essentialize this status-related category. Children's beliefs about SES did not vary with their social-status background. These findings suggest that the developmental trajectory of Chinese children's essentialist beliefs about social status vary across status-related categories, dimensions of essentialism, and their own social-status background.

INTRODUCTION: State and local jurisdictions in the United States (U.S.) are increasingly adopting flavored tobacco sales restrictions (FTSRs) to mitigate tobacco initiation and use. Policy implementation is highly understudied yet can impact policy effectiveness. This review examines existing literature on state and local FTSR policy design and implementation in the U.S. METHODS: We systematically searched for PubMed articles published by 12/31/2024 which were: original research articles in English focused on a U.S. state or local FTSR that reported at least one policy implementation outcome measure. We excluded articles that were systematic reviews or reported on federal or non-FTSR policy. Guided by policy and implementation science frameworks, we developed a data extraction template to report: policy design elements, study characteristics, and implementation measures (i.e., inputs, activities, outcomes). RESULTS: Of 1,595 articles identified, 30 were retained for review. Most evaluated local FTSRs, and eight evaluated a statewide policy. Pre-post test and cross-sectional study designs were the most common. Frequently reported implementation outcomes were acceptability, appropriateness, feasibility, and fidelity/compliance. Studies with pre-post test designs and comparison groups showed significantly increased fidelity/compliance (i.e., reduced availability of restricted products) in FTSR jurisdictions. A majority (56.7%) detailed an implementation input for infrastructure (e.g., resources) or activity (e.g., outreach). Few described enforcement-related mechanisms. CONCLUSIONS: Key gaps exist in policy implementation articles on state and local FTSRs in the U.S., including infrequent reporting of enforcement agencies and penalties which may impact implementation. Additional mixed methods research is needed to compare FTSR implementation across jurisdictions with varying policy designs.

Research on transgender health has expanded significantly within the past decade, yet the topic of transmasculine pregnancy remains underexplored. In this article, we extend the Gender Minority Stress Theory (GMST) to examine how psychosocial stressors faced by transmasculine individuals during pregnancy might influence gestational outcomes through key psychobiological pathways, including the HPA axis, immune, and cardiovascular systems. Specifically, we propose an adapted model that incorporates both proximal (e.g. internalized transphobia, concealment) and distal (e.g. discrimination, institutional exclusion) stressors specific to transmasculine pregnancy by synthesizing evidence that these psychosocial stressors are not only consequential for the mental and physical health of the pregnant person but may also have downstream effects on pregnancy outcomes. We also highlight certain personal and social psychosocial resilience resources that might buffer the impact of stressors on adverse outcomes. This model helps to identify novel pathways for intervention to promote the wellness of both the child and the transmasculine parent.

The remote Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education, enabling structured and objective assessment of clinical skills, communication, and patient-centered care. However, its widespread adoption has introduced challenges related to cost-effectiveness and efficient use of rater resources. Traditional double scoring (DS) ensures reliability but is labor-intensive and costly, especially in large-scale assessments. To address these challenges, this study introduces Targeted Double Scoring (TDS), a novel methodology that selectively applies DS to specific score ranges, particularly those near the pass/fail threshold. The study was conducted using data from a pilot remote OSCE administered to 550 clinical medicine undergraduates in China. The OSCE consisted of three stations: Clinical Reasoning (CR), Physical Examination (PE), and Fundamental Skills (FS). Each station was scored remotely by two raters, with a cut-off score of 60 out of 100. The TDS methodology was modeled based on the OSCE's DS design and fitted with scoring data. A decision-theoretic approach identified optimal Critical Score Ranges (CSRs) for targeted double scoring, balancing reliability and cost-effectiveness. The findings show that TDS significantly reduces rater workload and costs while maintaining high reliability and fairness. For instance, TDS achieved up to 70% cost savings compared to traditional DS under certain configurations. The study also highlights the flexibility of TDS, which can be tailored to different OSCE designs and scoring rubrics. These results have broad implications for medical education, especially in resource-constrained settings where optimizing assessment efficiency is critical. This study provides a practical solution to the cost-related challenges of remote OSCEs and offers a framework for adopting TDS in assessments. By focusing raters on critical score ranges, TDS maintains rigorous and fair evaluations without overburdening faculty or exceeding budgets. Future research should explore TDS scalability and its integration with emerging technologies like artificial intelligence to enhance efficiency and reliability.

Objectives: To determine the association between parent-reported problem behaviors and objectively measured response inhibition in children with sleep-disordered breathing (SDB). Understanding this concordance could facilitate better clinical decision-making, as parent reports often guide treatment decisions despite unclear relationships with objective behavioral measures. Methods: This prospective observational study was conducted at a tertiary care pediatric otolaryngology clinic from 1/1/24-12/1/2024. Children aged 5-11 years with SDB symptoms were included, while those with clinically significant psychiatric or neurologic disorders were excluded. Parent-reported problem behaviors were measured using the Behavior Rating Inventory of Executive Function (BRIEF), with the inhibit T-score as the primary predictor. The primary outcome was performance on the Flanker Test of Inhibitory Control and Attention, which measures response suppression to irrelevant stimuli while maintaining attention to target stimuli. Relationships between BRIEF scores and Flanker Test performance were assessed using Pearson correlation and linear regression, adjusting for sociodemographic factors. Results: Among 84 participants (mean age: 93 months [95% CI, 89-98], 56% male), parent-reported inhibitory problems showed a small but statistically significant correlation with response inhibition performance (r = -0.23, p = 0.04) in unadjusted analyses. This relationship was attenuated after adjusting for demographic and socioeconomic factors. Other behavioral domains showed weaker associations. Adjusted R ² values ranged 0.14-0.16, indicating parent reports explained minimal variance in objective scores. Conclusion: Parent-reported behavioral problems showed limited concordance with objective measures of response inhibition in children with SDB. Treatment decisions for pediatric SDB should not rely solely on parent-reported behavioral symptoms, highlighting the need for integrating objective assessments when feasible. Level of Evidence: 3.

Insufficient physical activity is a widespread health concern, necessitating the broad implementation of evidence-based behavior change interventions. Such evidence commonly derives from randomized controlled trials, but questions arise about who is willing to enroll and actively engage in such trials. This study investigated factors predicting engagement and retention in an online physical activity intervention for inactive parent-child dyads. Participants were recruited from the general Finnish population and assigned to either an intervention or wait-list control group. The intervention consisted of online materials, SMS prompts, and four online sessions. Partial least squares regression models were used to analyze autonomous motivation, parent and child gender, parental education, employment status, and recruitment source as predictors of intervention retention and engagement. Results showed that intervention retention was predicted by higher autonomous motivation, being a mother, social media recruitment, and university education. Session attendance was higher for autonomously motivated parents, fathers, parents of daughters, and university-educated parents. These findings highlight the importance of autonomous motivation and demographic factors in intervention engagement. However, the higher engagement of already motivated participants demonstrates challenges for reaching and intervening on those who might benefit most from such programs. Future research should explore strategies to engage and retain less motivated individuals and investigate reasons behind non-compliance to improve the effectiveness of physical activity interventions for inactive families.

OBJECTIVE: Sleep-disordered breathing (SDB) affects 10% of children and is associated with poor academic performance related to inattention and executive dysfunction. Yet, the underlying neural mechanisms remain poorly understood, especially in elementary school-aged children who cannot sit still for functional magnetic resonance imaging. This study examines the feasibility of using functional near-infrared spectroscopy (fNIRS), a child-friendly neuroimaging tool, to assess prefrontal cortex (PFC) activation in children with SDB. STUDY DESIGN: Prospective observational study between January and November 2024. SETTING: Tertiary care academic children's hospital. METHODS: We assessed 78 children aged 5 to 11 referred for management of clinically significant SDB. Participants completed a Go/No-Go task measuring response inhibition while undergoing fNIRS recording of PFC activity. Parent-reported SDB symptom burden was assessed using the Pediatric Sleep Questionnaire Sleep-Related Breathing Disorders scale. Executive function was assessed using the Behavior Rating Inventory of Executive Function (BRIEF) scores. RESULTS: Greater SDB symptom burden was associated with reduced PFC activation during the Go/No-Go task (r = -0.31, P = .028 in left middle frontal gyrus). Higher executive dysfunction correlated with lower PFC activation across multiple regions. The activation of the left dorsolateral PFC moderated the relationship between SDB symptoms and BRIEF Global Executive Composite (coefficient = -8.51, P = .039), suggesting neural compensation. CONCLUSION: This study demonstrates the feasibility of using task-based fNIRS to assess neural correlates of SDB in children. SDB symptoms are negatively associated with PFC activation, which may moderate the impact of SDB on behavior. These findings suggest fNIRS could be a practical tool for studying brain function in pediatric SDB.

Auditory exposure plays a crucial role in shaping brain development, but little is known about whether and how an initial lack of auditory exposure might disrupt the development of functional network lateralization. We addressed this issue by acquiring functional near-infrared spectroscopy data from infants aged 3 to 9 months with congenital sensorineural hearing loss (SNHL). The SNHL infants showed efficient small-world characteristics within each hemisphere. However, unlike typically developing controls, who showed an age-related leftward lateralization of network efficiencies, SNHL infants did not exhibit the emergence of hemispheric asymmetry. Intriguingly, lateralization of frontal efficiency was preserved in SNHL infants with mild hearing loss but declined significantly with increasing severity of hearing impairment. These findings suggest that even SNHL infants with some residual hearing experience disruption in the development of functional lateralization. This underscores the importance of providing early auditory access to SNHL infants to support robust functional integration during early development.

In three longitudinal studies, we examined the relationship between worry about an outcome and information-management behavior-specifically seeking and avoiding information about that outcome-in the context of awaiting uncertain news. Study 1 examined a group of U.S. voters across the 4 weeks preceding the 2020 presidential election. Study 2 examined law graduates who completed the California bar exam during the 17 weeks between when they took the exam and when their results were posted online. Study 3 examined job candidates from a variety of academic fields from October to April as they searched for academic jobs. In all three studies, people who reported greater worry about the relevant outcome across the wait reported greater information seeking. Additionally, people were particularly likely to seek information at the times during the wait when they reported the most acute worry. Evidence for the relationship between worry and information avoidance during the wait was more mixed; we found only that people who worried more were more likely to avoid information generally (between-subjects effect) in Studies 1 and 2 and did not find evidence that people were more likely to avoid at times they were most worried (within-subjects effect). These findings suggest that information avoidance might not be the strategy of choice in response to worry during stressful waiting periods; instead, worry seems to be motivating the pursuit of (sometimes unhelpful) information. (PsycInfo Database Record (c) 2025 APA, all rights reserved).