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Background

Chaotic homes predict poor school performance. Given that it is known that genes affect both children's experience of household chaos and their school achievement, to what extent is the relationship between high levels of noise and environmental confusion in the home, and children's school performance, mediated by heritable child effects? This is the first study to explore the genetic and environmental pathways between household chaos and academic performance.

Method

Children's perceptions of family chaos at ages 9 and 12 and their school performance at age 12 were assessed in more than 2,300 twin pairs. The use of child-specific measures in a multivariate genetic analysis made it possible to investigate the genetic and environmental origins of the covariation between children's experience of chaos in the home and their school achievement.

Results

Children's experience of family chaos and their school achievement were significantly correlated in the expected negative direction (r = −.26). As expected, shared environmental factors explained a large proportion (63%) of the association. However, genetic factors accounted for a significant proportion (37%) of the association between children's experience of household chaos and their school performance.

Conclusions

The association between chaotic homes and poor performance in school, previously assumed to be entirely environmental in origin, is in fact partly genetic. How children's home environment affects their academic achievement is not simply in the direction environment → child → outcome. Instead, genetic factors that influence children's experience of the disordered home environment also affect how well they do at school. The relationship between the child, their environment and their performance at school is complex: both genetic and environmental factors play a role.

Background

Chaotic homes predict poor school performance. Given that it is known that genes affect both children's experience of household chaos and their school achievement, to what extent is the relationship between high levels of noise and environmental confusion in the home, and children's school performance, mediated by heritable child effects? This is the first study to explore the genetic and environmental pathways between household chaos and academic performance.

Method

Children's perceptions of family chaos at ages 9 and 12 and their school performance at age 12 were assessed in more than 2300 twin pairs. The use of child-specific measures in a multivariate genetic analysis made it possible to investigate the genetic and environmental origins of the covariation between children's experience of chaos in the home and their school achievement.

Results

Children's experience of family chaos and their school achievement were significantly correlated in the expected negative direction (r = −0.26). As expected, shared environmental factors explained a large proportion (63%) of the association. However, genetic factors accounted for a significant proportion (37%) of the association between children's experience of household chaos and their school performance.

Conclusions

The association between chaotic homes and poor performance in school, previously assumed to be entirely environmental in origin, is in fact partly genetic. How children's home environment affects their academic achievement is not simply in the direction: environment → child → outcome. Instead, genetic factors that influence children's experience of the disordered home environment also affect how well they do at school. The relationship between the child, their environment, and their performance at school is complex: both genetic and environmental factors play a role.

Background:

There is limited data in the literature concerning the visual status and skills in children with learning disabilities, particularly within the Asian population. This study is aimed to determine visual acuity and visual skills in children with learning disabilities in primary schools within the suburban Kota Bharu district in Malaysia.

Methods:

We examined 1010 children with learning disabilities aged between 8–12 years from 40 primary schools in the Kota Bharu district, Malaysia from January 2009 to March 2010. These children were identified based on their performance in a screening test known as the Early Intervention Class for Reading and Writing Screening Test conducted by the Ministry of Education, Malaysia. Complete ocular examinations and visual skills assessment included near point of convergence, amplitude of accommodation, accommodative facility, convergence break and recovery, divergence break and recovery, and developmental eye movement tests for all subjects.

Results:

A total of 4.8% of students had visual acuity worse than 6/12 (20/40), 14.0% had convergence insufficiency, 28.3% displayed poor accommodative amplitude, and 26.0% showed signs of accommodative infacility. A total of 12.1% of the students had poor convergence break, 45.7% displayed poor convergence recovery, 37.4% showed poor divergence break, and 66.3% were noted to have poor divergence recovery. The mean horizontal developmental eye movement was significantly prolonged.

Conclusion:

Although their visual acuity was satisfactory, nearly 30% of the children displayed accommodation problems including convergence insufficiency, poor accommodation, and accommodative infacility. Convergence and divergence recovery are the most affected visual skills in children with learning disabilities in Malaysia.

Many schools are beginning to implement multi-tier response to intervention (RTI) models for the prevention of reading difficulties and to assist in the identification of students with learning disabilities (LD). The present study was part of our larger ongoing longitudinal RTI investigation within the Florida Learning Disabilities Center grant. This study used a longitudinal correlational design, conducted in 7 ethnically and socio-economically diverse schools. We observed reading instruction in 20 classrooms, examined response rates to kindergarten Tier 1 instruction, and predicted students’ first grade reading performance based upon kindergarten growth and end of year reading performance (n = 203). Teachers followed an explicit core reading program and overall, classroom instruction was rated as effective. Results indicate that controlling for students’ end of kindergarten reading, their growth across kindergarten on a variety of language and literacy measures suppressed predictions of first grade performance. Specifically, the steeper the students’ trajectory to a satisfactory outcome, the less likely they were to demonstrate good performance in first grade. Implications for future research and RTI implementation are discussed.

Objective

The goals of the review are threefold; a) to highlight the educational and employment consequences of poorly developed mathematical competencies; b) overview the characteristics of the children with persistently low achievement in mathematics; and c) provide a primer on cognitive science research that is aimed at identifying the cognitive mechanisms underlying these learning disabilities and associated cognitive interventions.

Method

Literatures on the educational and economic consequences of poor mathematics achievement were reviewed and integrated with reviews of epidemiological, behavioral genetic, and cognitive science studies of poor mathematics achievement.

Results

Poor mathematical competencies are common among adults and result in employment difficulties and difficulties in many common day-to-day activities. Among students, about 7% of children and adolescents have a mathematical learning disability (MLD) and another 10% show persistent low achievement (LA) in mathematics despite average abilities in most other areas. Children with MLD and their LA peers have deficits in understanding and representing numerical magnitude, difficulties retrieving basic arithmetic facts from long-term memory, and delays in learning mathematical procedures. These deficits and delays cannot be attributed to intelligence, but are related to working memory deficits for children with MLD, but not LA children. Interventions that target these cognitive deficits are in development and preliminary results are promising.

Conclusion

Mathematical learning disabilities and learning difficulties associated with persistent low achievement in mathematics are common and not attributable to intelligence. These individuals have identifiable number and memory delays and deficits that appear to be specific to mathematics learning. The most promising interventions are those that target these specific deficits and, in addition, for children with MLD interventions that target their low working memory capacity.

The effect of school meals on the rate of growth was assessed in two sets of children over one, two, and three-year periods in England and Scotland between 1973 and 1979. In all analyses children were subdivided into three groups: poor, not poor, and undefined, according to a set of questions on social circumstances. The rate of growth was assessed for children receiving school meals, lunches prepared at home, and those who changed scheme during the study period. No relation between rate of growth and uptake of school meals was found at any of the levels of poverty in England. In Scotland there was some indication in the poor group that children who received school meals had a smaller rate of growth than children having lunches prepared at home. There was inconclusive evidence that children from the poorer sectors of the community whose mother's worked outside the home may benefit from the school meals system. Although children selected for welfare support were smaller than other children, in so far as the design of the study allowed school meals during the 1970s did not increase the rate of growth of primary school children in any social stratum.

Background

Carers of children with disabilities have repeatedly highlighted their feelings of discrimination, stigma and exclusion in many domains of their lives. There is little research from Africa addressing these issues. This study investigated the challenges encountered by these carers and the mechanisms of coping with these challenges while caring for children with disabilities in a poor rural setting in Kenya.

Methods

Thirty-five in-depth interviews were conducted with 20 carers, 10 community members and 5 primary school teachers. Ten unstructured observations were also conducted in home environments to observe mechanisms used in meeting the needs of the children with disabilities. All interviews were tape-recorded, transcribed and translated from the local dialect. Note-taking was performed during all the observations. Data were stored in NVivo software for easy retrieval and management.

Results

The arrival of a disabled child severely impairs the expectations of carers. Hospital staff underestimate carers' emotional distress and need for information. Fear for the future, stress, rumour-mongering and poverty are encountered by carers. As they grapple with lost expectations, carers develop positive adaptations in the form of learning new skills, looking for external support and in some cases searching for cure for the problem. For their emotional stability, carers apply spiritual interventions and sharing of experiences.

Conclusion

Despite the challenges faced by the carers, values and priorities in adaptation to the challenges caused by the child's disability were applied. It is recommended that these experiences are considered as they may influence programmes that address the needs of children with disabilities.

AIM—To evaluate academic career in long term survivors of childhood acute lymphoblastic leukaemia (ALL), in comparison to their healthy siblings.
PATIENTS—Ninety four children treated for ALL with cranial irradiation 18 or 25 Gy and intrathecal methotrexate as CNS prophylaxis. Median age at evaluation was 20 years; median follow up since diagnosis was 15 years at the time of the study.
METHODS—Patients and their 134 siblings completed a questionnaire on school career. The percentage of referrals to special primary schools for learning disabled, and the final level of secondary education in patients and siblings were compared, using a six point classification. Within the patient group, the effect of possible risk factors (age at diagnosis, irradiation dose, and gender) was investigated.
RESULTS—Significantly more patients than siblings were placed in special educational programmes. A significant difference was found for level of secondary education. No effect of gender or irradiation dose was found, but younger age at diagnosis was significantly related to both referrals and school levels.
CONCLUSION—Treatment for childhood ALL with cranial irradiation and chemotherapy at a young age is clearly associated with poorer academic career.



Background

Having a child with a disability is a heavy burden for mothers, especially in developing countries, where there is little available financial or other government support. Having a child with a disability is also linked to mental health problems and poor quality of life. Communities rich in social capital and individuals who have high levels of personal social capital generally enjoy day-to-day and long-term health and social benefits but this has not been investigated in Vietnam among mothers of children with disabilities. This study aims to investigate these mothers’ distress in terms of their social capital.

Methods

A cross-sectional study based on an interviewer-assisted survey included 172 mothers of children with moderate/severe disabilities in two provinces of Vietnam (one in the North and one in central Vietnam), using a newly translated and modified version of the Australian community participation questionnaire, several measures of personal social cohesion, and Kessler's 10-item measure of general psychological distress. Hierarchical linear regression modelling was used to explore the relationships among socio-demographic factors, multiple components of structural and cognitive social capita, and mothers’ distress controlling for a wide range of socio-demographic characteristics, the nature of the child's disability, and mothers’ personality (extroversion).

Results

Mothers in this study were highly and multiply disadvantaged, and they had very high levels of distress and low levels of community participation. Furthermore, most forms of participation were associated with greater, not less, distress. Socio-demographic characteristics, child's disability, and mothers’ personality did little to explain variance in mothers’ distress, but types and amounts of participation were important predictors. The final regression model explained 29% of variance in distress, with major contributions made by living in a mountainous area, having a ‘reserved’ personality, and frequency and types of participation.

Conclusion

Vietnamese mothers whose children have disabilities are extremely marginalised and distressed. They have only modest social capital, but the little they have tends to be related to better mental health. Being from the mountains; being ‘reserved’; spending time with friends, neighbours, and in educational activities; and trusting others are related to better mental health among these women. However, several types of participation are associated with worse mental health. Such activities should be avoided in any interventions designed to increase social capital as a mental health promotion strategy.

Motivational theorists in psychology have moved away from individual-based approaches to socio-cognitive and socio-ecological models to explain student engagement and motivation for learning. Such approaches consider, for example, the influence of family and neighborhood environments as important constructs in youth behavior. In this study, links between neighborhood condition (e.g. external appearance of the blocks nearest to the respondents’ home), family dysfunction, and motivation for learning are investigated. Data were obtained from two hundred and sixteen (216) urban African American middle school children enrolled in a substance use prevention intervention. Analytic models show associations between poor neighborhood condition and both family dysfunction and lower learning motivation. Family dysfunction was also found to mediate the effect of neighborhood condition on motivated learning. Neighborhood and family characteristics are important determinants of urban schoolchildren’s motivation for learning.

Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported evaluation of mathematics, and math anxiety in 140 primary school children between the end of first grade and the middle of third grade. Structural equation modeling revealed a strong influence of calculation ability and math anxiety on the evaluation of mathematics but no effect of math anxiety on calculation ability or vice versa—contrasting with the frequent clinical reports of math anxiety even in very young MLD children. To summarize, our study is a first step toward a better understanding of the link between math anxiety and math performance in early primary school years performance during typical and atypical courses of development.

Background

Regular participation in physical activities is important for all children to stay fit and healthy. Children with cerebral palsy have reduced levels of physical activity, compared to typically developing children. The aim of the LEARN 2 MOVE 7-12 study is to improve physical activity by means of a physical activity stimulation program, consisting of a lifestyle intervention and a fitness training program.

Methods/Design

This study will be a 6-month single-blinded randomized controlled trial with a 6-month follow up. Fifty children with spastic cerebral palsy, aged 7 to 12 years, with Gross Motor Function Classification System levels I-III, will be recruited in pediatric physiotherapy practices and special schools for children with disabilities. The children will be randomly assigned to either the intervention group or control group. The children in the control group will continue with their regular pediatric physiotherapy, and the children in the intervention group will participate in a 6-month physical activity stimulation program. The physical activity stimulation program consists of a 6-month lifestyle intervention, in combination with a 4-month fitness training program. The lifestyle intervention includes counseling the child and the parents to adopt an active lifestyle through Motivational Interviewing, and home-based physiotherapy to practise mobility-related activities in the daily situation. Data will be collected just before the start of the intervention (T0), after the 4-month fitness training program (T4), after the 6-month lifestyle intervention (T6), and after six months of follow-up (T12). Primary outcomes are physical activity, measured with the StepWatch Activity Monitor and with self-reports. Secondary outcomes are fitness, capacity of mobility, social participation and health-related quality of life. A random coefficient analysis will be performed to determine differences in treatment effect between the control group and the intervention group, with primary outcomes and secondary outcomes as the dependent variables.

Discussion

This is the first study that investigates the effect of a combined lifestyle intervention and fitness training on physical activity. Temporary effects of the fitness training are expected to be maintained by changes to an active lifestyle in daily life and in the home situation.

Trial registration

This study is registered in the Dutch Trial Register as NTR2099.

Background

Cerebral palsy (CP) is the most common cause of physical disability in children but its impact on quality of life is not well understood. This study examined participation in everyday activities among children without CP and children with mild, moderate and severe impairment due to CP. We then examined ten domains of quality of life in children with CP and investigated whether participation in everyday activities was associated with improved quality of life independent of gender, age and level of impairment.

Methods

This was a cross-sectional study of children aged 8–12 years based on two questionnaires, frequency of participation (FPQ) and KIDSCREEN, completed by parents of 98 children on the South of Ireland Cerebral Palsy Register (response rate = 82%) and parents of 448 children attending two Cork city schools (response rate = 69%) who completed one questionnaire (FPQ). Multiple linear regression was used: firstly to estimate the effect of severity of CP on participation in everyday activities independent of age and gender and secondly we estimated the effect of participation on quality of life independent of age gender and level of impairment.

Results

Participation in 11 of the 14 everyday activities examined varied across the children without CP and the children with varying severity of CP. In general, increased impairment decreased participation. Independent of age and gender, there was a highly significant decrease in overall participation with a fall of -6.0 (95% CI = -6.9 to -5.2) with each increasing level of impairment. The children with CP generally had high quality of life. Increased impairment was associated with diminished quality of life in just two domains – Physical well-being and Social support and peers. Overall participation in everyday activities was significantly associated with quality of life in 3 of the 10 domains (Physical well-being, Social support and peers & Moods and emotions) in analysis adjusted for gender age and level of impairment.

Conclusion

While increased impairment due to CP restricts participation in the majority of everyday activities, the level of participation has a limited effect on the quality of life of the children with CP in age 8–12 years.

The progress is described of the longtudinal cohort study based on all children born in England, Scotland and Wales in one week of April 1970. The children and their mothers have been surveyed at birth, at five, and recently, at ten. Analyses of the data presented include the finding of improved intellectual outcome in children who had been immunized against pertussis, compared with poor intellectual outcome in children who had had hospital admissions for the disease itself. Preliminary data collected at 10 show that routine hearing and vision testing during the child's school life fell short of recommended standards. The major aim of the 10-year-old contact, however, is to establish details of the national prevalence and pathogenesis of disability. The identification of disability uses a life skills questionnaire, medical history and examination.

Does achievement independent of ability or previous attainment provide a purer measure of the added value of school? In a study of 4000 pairs of 12-year-old twins in the UK, we measured achievement with year-long teacher assessments as well as tests. Raw achievement shows moderate heritability (about 50%) and modest shared environmental influences (25%). Unexpectedly, we show that for indices of the added value of school, genetic influences remain moderate (around 50%), and the shared (school) environment is less important (about 12%). The pervasiveness of genetic influence in how and how much children learn is compatible with an active view of learning in which children create their own educational experiences in part on the basis of their genetic propensities.

Background

Despite wide recognition that children with disability often have poor oral health, few high quality, controlled results are available.

Method

Twenty-four objective and subjective criteria covering feeding, autonomy, access to dental care, oral hygiene, oral disease, general health and behavior were evaluated in a observational cross-sectional study of 2,487 children with disability (DC group), 4,772 adolescents with disability (DA group) and 1,641 children without disability (NDC group). Five algorithms ranked the subjects according to clinical criteria in three original oral health indices: the Clinical Oral Health Index (COHI), indicating the level of oral health problems, the Clinical Oral Care Needs Index (COCNI) giving dental care need levels, and the Clinical Oral Prevention Index (COPI) determining possible needs in terms of dental education initiatives.

Results

DC-group children presented poorer oral health and had greater needs in both treatment and preventive oral health actions than NDC-group children (OR = 3.97, 95% CI = 3.25–4.86 for COHI; OR = 2.01, 95% CI = 1.77–2.28 for COCNI; OR = 5.25, 95% CI = 4.55–6.02 for COPI). These conditions were worse again in the DA group comparing to the DC group (OR = 3.52, 95% CI = 2.7–4.6 for COHI; OR = 1.52, 95% CI = 1.38–1.69 for COCNI; OR = 1.53, 95% CI = 1.39–1.69 for COPI).

Conclusion

Clinical indices generated by algorithmic association of various clinical indicators allow sensitive clinical measurement, and in this study demonstrated inequalities in oral health for children with disabilities schooling in institutions. Questions need now to be addressed as to the measures that could be taken to compensate for this situation.

Purpose

The purpose of this study is to investigate parent reports of the diabetes care support their children receive in school, their concerns about diabetes management in school, and their knowledge of federal laws that protect children with diabetes. In addition, the study explores ethnic and socioeconomic status differences in diabetes management in school.

Methods

An ethnically heterogeneous sample of 309 parents of children with diabetes was recruited from a community-based and a university-based diabetes outpatient clinic. Parents completed a survey assessing supports their child's school provides for diabetes care, worries about diabetes care in school, and awareness of federal laws that pertain to children with diabetes.

Results

Many children did not have a written care plan or a nurse at school, but significantly more white children had these supports than Hispanic or black children. Most children were not allowed to check blood glucose levels or administer insulin in class. Most parents were worried about hyperglycemia and hypoglycemia in school, and most were not at all or only a little confident in the school's ability to care for diabetes. Most parents were not aware of federal laws, but high-income and white parents were more likely to be aware.

Conclusions

According to parents in the current study, children receive inadequate diabetes management support in schools. Minority children are less likely to receive supports than white children. Parents are worried about diabetes management in school, but most do not have the knowledge of federal laws necessary to protect their children.

Family-school collaboration related to children’s physical development has become increasingly important as childhood obesity rates continue to rise. The present study described the development and implementation of a literacy-based, family component of a school-based health education program and investigated its viability, acceptability, and effectiveness. Interactive children’s books were the mechanism by which students, parents, and teachers received consistent messages at home and school regarding nutrition information. The home-school intervention served to bridge home and school cultures in an urban population. Preliminary process evaluation results indicated that the interactive children’s books were feasible to implement in the school context. Parents, children, and teachers had positive perceptions of the books. Parents who received the books demonstrated increased knowledge of 5 a Day, the primary nutrition message communicated in the program. Although not statistically significant, after the first and second years of intervention, parents in the experimental group reported that their children were eating 0.54 and 0.36 additional servings of fruit and vegetables per day compared with children in the control group. The program did not seem to impact the availability and accessibility of fruits and vegetables at home.

For children living with long-term illness, school age is a risk period with regard to psychosocial ill health and poor compliance with treatment. There is a need for methods to promote health, well-being, and self-esteem. This study describes a new concept for supporting children, person-centred web-based learning and support, which has been tested in 12 preschool children and incorporates learning about feelings, relationships, and the right to integrity. SKYPE was used for conversations between the child and the web teacher. Methods. The programme was developed and tested in two steps. The conversations were tape-recorded and analysed using phenomenography. The questions addressed concerned the quality of the intervention process: accessibility of intervention, learning content and support, and identification of measurable items and patterns. Findings. The children found it interesting to communicate with their web teacher using SKYPE. The story about Max and Sara served as a good basis for discussion, and development was found in the learning process. The children were able to talk about relations and feelings and developed an understanding for use in new situations in their daily lives. Items and patterns that are useful for research and documentation were identified, for example, well-being, resources, needs, and wishes.

Background

School based mental health programs are absent in most educational institutions for intellectually disabled children and adolescents in Nigeria and co-morbid behavioral problems often complicate intellectual disability in children and adolescents receiving special education instructions. Little is known about prevalence and pattern of behavioral problems existing co-morbidly among sub-Saharan African children with intellectual disability. This study assessed the prevalence and pattern of behavioral problems among Nigerian children with intellectual disability and also the associated factors.

Method

Teachers' rated Strengths and Difficulties Questionnaire (SDQ) was used to screen for behavioral problems among children with intellectual disability in a special education facility in south eastern Nigeria. Socio-demographic questionnaire was used to obtain socio-demographic information of the children.

Results

A total of forty four (44) children with intellectual disability were involved in the study. Twenty one (47.7%) of the children were classified as having behavioral problems in the borderline and abnormal categories on total difficulties clinical scale of SDQ using the cut-off point recommended by Goodman. Mild mental retardation as compared to moderate, severe and profound retardation was associated with highest total difficulties mean score. Males were more likely to exhibit conduct and hyperactivity behavioral problems compared to the females. The inter-clinical scales correlations of teachers' rated SDQ in the studied population also showed good internal consistency (Cronbach Alpha = 0.63).

Conclusion

Significant behavioral problems occur co-morbidly among Nigerian children with intellectual disability receiving special education instructions and this could impact negatively on educational learning and other areas of functioning. There is an urgent need for establishing school-based mental health program and appropriate screening measure in this environment. These would afford early identification of intellectually disabled children with behavioral problems and appropriate referral for clinical evaluation and interventions. The need to focus policy making attention on hidden burden of intellectual disability in sub-Saharan African children is essential.

Developmental disorders such as attention-deficit/hyperactivity disorder (ADHD) and Asperger syndrome (AS) are often associated with learning disabilities. This study investigated the explicit learning of visuomotor sequences in 17 ADHD children (mean age 12.1), 21 AS children (mean age 12.7), and 15 typically developing children (mean age: 12.3). The participants were required to explore a hidden sequence of button presses by trial and error and elaborate the learned sequence (2 × 10 task: Hikosaka et al. 1996). The results indicated that although ADHD and AS children had a tendency of repeating the same errors and took longer to complete a sequence, both showed a degree and pattern of improvement in accuracy and speed similar to that of typically developing children. These results suggest that the explicit learning of visuomotor sequence in ADHD and AS patients is largely unimpaired.

Electronic supplementary material

The online version of this article (doi:10.1007/s00221-010-2217-3) contains supplementary material, which is available to authorized users.

Objectives

It is well documented that early-learning problems and poor academic achievement adversely impact child development and a wide range of adult outcomes; however, these indicators have received scant attention among homeless adults. This study examines self-reported learning disabilities (LD) in childhood as predictors of duration of homelessness, mental and substance use disorders, physical health, and service utilisation in a sample of homeless adults with current mental illness.

Design

This study was conducted using the baseline sample from a randomised controlled trial (RCT).

Setting

Participants were sampled from the community in Vancouver, British Columbia.

Participants

The total sample included 497 adult participants who met criteria for absolute homelessness or precarious housing and a current mental disorder based on a structured diagnostic interview. Learning disabilities in childhood were assessed by asking adult participants whether they thought they had an LD in childhood and if anyone had told them they had an LD. Only participants who responded positively to both questions (n=133) were included in the analyses.

Outcome measures

Primary outcomes include current mental disorders, substance use disorders, physical health, service utilisation and duration of homelessness.

Results

In multivariable regression models, self-reported LD during childhood independently predicted self-reported educational attainment and lifetime duration of homelessness as well as a range of mental health, physical health and substance use problems, but did not predict reported health or justice service utilisation.

Conclusions

Childhood learning problems are overrepresented among homeless adults with complex comorbidities and long histories of homelessness. Our findings are consistent with a growing body of literature indicating that adverse childhood events are potent risk factors for a number of adult health and psychiatric problems, including substance abuse.

Trials registration number

This trial has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374.

Although the past few decades have seen rising incomes and increased government attention to rural development, many children in rural China still lack regular access to micronutrient-rich diets. Insufficient diets and poor knowledge of nutrition among the poor result in nutritional problems, including iron-deficiency anaemia, which adversely affect attention and learning of students in school. Little research has been conducted in China documenting the prevalence of nutritional problems among vulnerable populations, such as school-age children, in rural areas. The absence of programmes to combat anaemia among students might be interpreted as a sign that the Government does not recognize its severity. The goals of this paper were to measure the prevalence of anaemia among school-age children in poor regions of Qinghai and Ningxia, to identify individual-, householdand school-based factors that correlate with anaemia in this region, and to report on the correlation between the anaemic status and the physical, psychological and cognitive outcomes. The results of a cross-sectional survey are reported here. The survey involved over 4,000 fourth and fifth grade students from 76 randomly-selected elementary schools in 10 poor counties in rural Qinghai province and Ningxia Hui Autonomous Region, located in the northwest region of China. Data were collected using a structured questionnaire and standardized tests. Trained professional nurses administered haemoglobin (Hb) tests (using Hemocue finger prick kits) and measured heights and weights of children. The baseline data showed that the overall anaemia rate was 24.9%, using the World Health Organization's blood Hb cut-offs of 120 g/L for children aged 12 years and older and 115 g/L for children aged 11 years and under. Children who lived and ate at school had higher rates of anaemia, as did children whose parents worked in farms or were away from home. Children with parents who had lower levels of education were more likely to be anaemic. The anaemic status correlated with the adverse physical, cognitive and psychological outcomes among the students. Such findings are consistent with findings of other recent studies in poor, northwest areas of China and led to conclude that anaemia remains a serious health problem among children in parts of China.

The present study investigated demographic differences in school readiness within Jordan, a particularly interesting context because of wide-spread national reform currently sweeping the education system in Jordan. Teacher reports and researcher direct assessments of the school readiness of a national sample of 4,681 Jordanian first grade children were used to describe the levels of school readiness of children with respect to seven demographic characteristics. Higher levels of school readiness were associated with male gender, higher family income, higher paternal education, higher maternal education, smaller family size, fewer siblings, and urban residence. Taken together, the findings highlight the importance of Jordanian education reform, one aim of which is to improve the school readiness of all children by implementing public kindergartens, especially in poor, rural areas.

This study used simulation techniques to evaluate the technical adequacy of three methods for the identification of specific learning disabilities via patterns of strengths and weaknesses in cognitive processing. Latent and observed data were generated and the decision-making process of each method was applied to assess concordance in classification for specific learning disabilities between latent and observed levels. The results showed that all three methods had excellent specificity and negative predictive values, but low to moderate sensitivity and very low positive predictive values. Only a very small percentage of the population (1%–2%) met criteria for specific learning disabilities. In addition to substantial psychometric issues underlying these methods, general application did not improve the efficiency of the decision model, may not be cost effective because of low base rates, and may result in many children receiving instruction that is not optimally matched to their specific needs.