Although children enact third-party punishment, at least in response to harm and fairness violations, much remains unknown about this behavior. We investigated the tendency to make the punishment fit ...the crime in terms of moral domain; developmental patterns across moral domains; the effects of audience and descriptive norm violations; and enjoyment of inflicting punishment. We tested 5- to 11-year-olds in the United Kingdom (N = 152 across two experiments, 55 girls and 97 boys, predominantly White and middle-class). Children acted as referees in a computer game featuring teams of players: As these players violated fairness or loyalty norms, children were offered the opportunity to punish them. We measured the type (fining or banning) and severity of punishment children chose and their enjoyment in doing so. Children only partially made the punishment fit the crime: They showed no systematic punishment choice preference for disloyal players, but tended to fine rather than ban players allocating resources unfairly-a result best explained by equalization concerns. Children's punishment severity was not affected by audience presence or perpetrators' descriptive norm violations, but was negatively predicted by age (unless punishment could be used as an equalization tool). Most children did not enjoy punishing, and those who believed they allocated real punishment reported no enjoyment more often than children who believed they pretended to punish. Contrary to predictions, retribution was not a plausible motive for the observed punishment behavior. Children are likely to have punished for deterrence reasons or because they felt they ought to.
IntroductionRoutines, particularly at bedtime are often recommended as a first line treatment for many common child sleep problems (CSPs). Research has demonstrated the benefits of consistent ...routines for child sleep in a number of domains, however many parents report using routines inconsistently. Research has found that positive caregiver feelings about bedtime routines can motivate their implementation, while negative feelings have been associated with reduced use of routines. Caregiver feelings about sleep-related routines could also affect child sleep directly through the pre-sleep emotional climate experienced by the child and could have repercussions for caregiver mental health. However the range of caregiver feelings in relation to their children’s sleep-related routines has not been fully explored. This study therefore set out to answer the research question ‘What feelings do parents experience in relation to their sleep-related routines with their toddlers?’MethodThis was a qualitative study based on semi-structured online interviews with 21 mothers of 1–3 year olds. Parents were asked to narrate the sleep-related practices they typically used over the 24-hour sleep/wake cycle with their toddlers and how they felt during and about their routines. Data were analysed using reflexive thematic analysis.ResultsNine themes were identified, two with associated subthemes. Participants reported positive feelings of happiness and enjoyment, relaxation and freedom, and negative feelings of guilt, sadness, restriction, frustration, worry and uncertainty about their sleep-related routines. Many also reported a neutral feeling of acceptance. DiscussionCaregivers can experience a wide range of positive and negative feelings in relation to their sleep-related routines with their 1–3 year olds, which may be beneficial or detrimental to both their child’s sleep and their own mental health. Assessment of routines and advice on implementation should take account of caregivers’ emotional experiences and be tailored to individual families’ values, preferences and priorities.1–9ReferencesBraun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology, 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oaBraun V, Clarke V. Thematic analysis: A practical guide. SAGE. 2022.Dahl RE. The regulation of sleep and arousal: development and psychopathology. Development and Psychopathology, 1996;8(1):3–27. https://doi.org/10.1017/S0954579400006945Hoyniak CP, Bates JE, McQuillan ME, Albert LE, Staples AD, Molfese VJ, Rudasill KM, Deater-Deckard K. The Family Context of Toddler Sleep: Routines, Sleep Environment, and Emotional Security Induction in the Hour before Bedtime. Behavioral Sleep Medicine, 2021;19(6):795–813, https://doi.org/10.1080/15402002.2020.1865356Jones CHD, Ball HL. Napping in English preschool children and the association with parents’ attitudes. Sleep Medicine, 2013;14(4):352–358. https://doi.org/10.1016/j.sleep.2012.12.010Jones C, Ball H. Exploring socioeconomic differences in bedtime behaviours and sleep duration in English preschool children. Infant and Child Development, 2014;23(5):518–531. https://doi.org/10.1002/icd.1848Kitsaras G, Goodwin M, Kelly M, Pretty I, Allan J. Perceived barriers and facilitators for bedtime routines in families with young children. Children, 2021;8(50). https://doi.org/10.3390/children8010050Mindell J, Williamson A. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Medicine Reviews, 2018;40:93–108. https://doi.org/10.1016/j.smrv.2017.10.007Sundnes A, Andenaes A. Parental regulation of infant sleep: Round-the-clock efforts for social synchronization. Infant Mental Health Journal, 2016;37(3):247–258. https://doi.org/10.1002/imhj.21568
To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD).
This phase III trial was a randomized, ...placebo-controlled crossover design. Participants were aged between 5 years and 16 years 10 months, with a confirmed ASD diagnosis and severe sleep problems, refractory to community-based interventions. The interventions were either a commercially available weighted blanket or otherwise identical usual weight blanket (control), introduced at bedtime; each was used for a 2-week period before crossover to the other blanket. Primary outcome was total sleep time (TST) recorded by actigraphy over each 2-week period. Secondary outcomes included actigraphically recorded sleep-onset latency, sleep efficiency, assessments of child behavior, family functioning, and adverse events. Sleep was also measured by using parent-report diaries.
Seventy-three children were randomized and analysis conducted on 67 children who completed the study. Using objective measures, the weighted blanket, compared with the control blanket, did not increase TST as measured by actigraphy and adjusted for baseline TST. There were no group differences in any other objective or subjective measure of sleep, including behavioral outcomes. On subjective preference measures, parents and children favored the weighted blanket.
The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period.
Many of the same sleep problems seen in typically developing (TD) children are frequently experienced by children with epilepsy (CWE). Behavioural sleep interventions (BSIs) are commonly and ...successfully used to treat these sleep problems in TD children and in some neurodevelopmental disorder populations. Therefore, BSIs should be effective in CWE, however, there are special seizure-related considerations for CWE and their parents which may be salient to consider in any future BSI development for this group. The current study sought to identify, from parents, if there were special considerations for the content and delivery of an online BSI for parents of CWE. Semi-structured interviews were conducted with nine mothers of CWE and thematic analysis was conducted on the interview data. Ten themes were apparent which represented what parents wanted from any online BSI for CWE. Parents wanted (i) other parents’ views and real-life experiences to be included, (ii) recognition of how changes over time may influence the appropriateness of using various sleep-management options, (iii) to be presented with a range of sleep management options from which they could select, (iv) personalised information and suggestions for behaviour-change options, (v) help to address child anxiety around sleep, (vi) for the advice and behaviour-change options to be practical, (vii) general educational information about sleep and the relationship between sleep and epilepsy, (viii) for parental worries and concerns to be acknowledged, (ix) to receive help, support, and reassurance around children’s sleep; and (x) to include the child in the intervention. It was clear that any online BSI would require specific adaptations and additions (to content and delivery format) to best meet the needs of parents of CWE. It is hoped that having identified what parents want from on online BSI for CWE will allow these factors to be acknowledged in future intervention development, with the intention to optimise parental engagement and intervention effectiveness. Practical suggestions for how these aspects could be integrated into any online BSI are suggested.
Many of the sleep problems experienced by children with epilepsy (CWE) have the same behavioural basis as common sleep problems seen in typically developing (TD) children. Behavioural sleep ...interventions (BSIs) are widely used to treat these sleep problems in TD children and are hypothesised to be effective for CWE. However, specific considerations need to be addressed and incorporated into a BSI for CWE to ensure the intervention is tailored to this population's needs. This paper details developing and tailoring an online BSI for parents of CWE, to be used in the CASTLE (Changing Agendas on Sleep, Treatment and Learning in Epilepsy) Sleep-E clinical trial.
In phase one, two existing theory-driven paediatric BSIs were adapted into a novel online behavioural sleep intervention (CASTLE Online Sleep Intervention or COSI) which specifically incorporated the needs and requirements reported by nine parents of CWE. Scoping their needs included conducting interviews with three CWE so that they could contribute to the overall intervention content. In phase two, six of these parents evaluated COSI, reviewing and feeding back on COSI until parental approval for content and functionality was achieved.
In phase one, a range of adaptations was made to the content and presentation of standardised intervention material to acknowledge and emphasise the key seizure-specific issues to ensure COSI best met parents of CWE's needs. Adaptations included embedding parent and child experiences in the intervention, including particular information requested by parents, such as the links between sleep and seizures and managing child and parental anxieties around sleep, as well as developing functionality to personalise the delivery of content. In phase two, parents confirmed that they found the final version of COSI to be functional and appropriate (after one round of review) for use by parents of CWE and that 100% would recommend it to other families who have CWE.
It is hoped that the use of evidence-based BSIs, adapted to consider salient epilepsy-specific factors, will increase parent-engagement, COSI's relevance for this particular patient group and overall efficacy in improving sleep in CWE. The effectiveness of COSI will be tested in the CASTLE Sleep-E clinical trial (https://castlestudy.org.uk/).
•Experience of ASMR is associated with increased relaxation and improved mood.•Positive effects of ASMR may be notable for adults with symptoms of depression.•Positive effects of ASMR are greater in ...adults with symptoms of depression than insomnia.•ASMR videos have the potential to improve mood and reduce arousal.•ASMR videos have the potential to alleviate symptoms of insomnia and depression.
Autonomous Sensory Meridian Response (ASMR) is a pleasant physiological tingling sensation induced by certain visual and auditory triggers. ASMR has been shown to reduce stress and increase positive mood, but its effects have not yet been studied in populations with clinically severe symptoms. The present study aimed to investigate whether the experience of ASMR improved mood and reduced arousal in people with and without insomnia and depression symptoms.
1,037 participants (18–66 years) completed online questionnaires assessing insomnia and depression symptom severity followed by questionnaires on current mood and arousal levels before and after watching an ASMR video. The independent variables were the participant's group (insomnia, depression, insomnia and depression combined or control) and whether they experienced ASMR during the video. The dependent variables were the change in mood and arousal levels after watching the video.
As predicted, all participants showed significantly increased relaxation and improved mood after watching the video with the largest effects for participants who experienced ASMR and for participants in the combined and depression groups. No difference was found between the insomnia and control groups.
It is not known how many participants were familiar with ASMR videos prior to taking part in the study (nor whether this is important). Also, the categorization of participants into the ASMR group was based on self-report and thus, not verified.
Results suggest that ASMR videos have the potential to be used to improve mood and reduce arousal with implications for alleviating symptoms of insomnia and depression.
In paediatric epilepsy, the evidence of effectiveness of antiseizure treatment is inconclusive for some types of epilepsy. As with other paediatric clinical trials, researchers undertaking paediatric ...epilepsy clinical trials face a range of challenges that may compromise external validity MAIN BODY: In this paper, we critically reflect upon the factors which impacted recruitment to the pilot phase of a phase IV unblinded, randomised controlled 3×2 factorial trial examining the effectiveness of two antiseizure medications (ASMs) and a sleep behaviour intervention in children with Rolandic epilepsy. We consider the processes established to support recruitment, public and patient involvement and engagement (PPIE), site induction, our oversight of recruitment targets and figures, and the actions we took to help us understand why we failed to recruit sufficient children to continue to the substantive trial phase. The key lessons learned were about parent preference, children's involvement and collaboration in decision-making, potential and alternative trial designs, and elicitation of stated preferences pre-trial design. Despite pre-funding PPIE during the trial design phase, we failed to anticipate the scale of parental treatment preference for or against antiseizure medication (ASMs) and consequent unwillingness to be randomised. Future studies should ensure more detailed and in-depth consultation to ascertain parent and/or patient preferences. More intense engagement with parents and children exploring their ideas about treatment preferences could, perhaps, have helped predict some recruitment issues. Infrequent seizures or screening children close to natural remission were possible explanations for non-consent. It is possible some clinicians were unintentionally unable to convey clinical equipoise influencing parental decision against participation. We wanted children to be involved in decisions about trial participation. However, despite having tailored written and video information to explain the trial to children we do not know whether these materials were viewed in each consent conversation or how much input children had towards parents' decisions to participate. Novel methods such as parent/patient preference trials and/or discrete choice experiments may be the way forward.
The importance of diligent consultation, the consideration of novel methods such as parent/patient preference trials and/or discrete choice experiments in studies examining the effectiveness of ASMs versus no-ASMs cannot be overemphasised even in the presence of widespread clinician equipoise.
IntroductionSleep and epilepsy have an established bidirectional relationship yet only one randomised controlled clinical trial has assessed the effectiveness of behavioural sleep interventions for ...children with epilepsy. The intervention was successful, but was delivered via face-to-face educational sessions with parents, which are costly and non-scalable to population level. The Changing Agendas on Sleep, Treatment and Learning in Epilepsy (CASTLE) Sleep-E trial addresses this problem by comparing clinical and cost-effectiveness in children with Rolandic epilepsy between standard care (SC) and SC augmented with a novel, tailored parent-led CASTLE Online Sleep Intervention (COSI) that incorporates evidence-based behavioural components.Methods and analysesCASTLE Sleep-E is a UK-based, multicentre, open-label, active concurrent control, randomised, parallel-group, pragmatic superiority trial. A total of 110 children with Rolandic epilepsy will be recruited in outpatient clinics and allocated 1:1 to SC or SC augmented with COSI (SC+COSI). Primary clinical outcome is parent-reported sleep problem score (Children’s Sleep Habits Questionnaire). Primary health economic outcome is the incremental cost-effectiveness ratio (National Health Service and Personal Social Services perspective, Child Health Utility 9D Instrument). Parents and children (≥7 years) can opt into qualitative interviews and activities to share their experiences and perceptions of trial participation and managing sleep with Rolandic epilepsy.Ethics and disseminationThe CASTLE Sleep-E protocol was approved by the Health Research Authority East Midlands (HRA)–Nottingham 1 Research Ethics Committee (reference: 21/EM/0205). Trial results will be disseminated to scientific audiences, families, professional groups, managers, commissioners and policymakers. Pseudo-anonymised individual patient data will be made available after dissemination on reasonable request.Trial registration numberISRCTN13202325.
...there is a wide array of outcome variables which will be imperative to consider when trying to determine the significance of any variations in napping.
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