The study, led by Molly Yeoman with colleagues including Vaso Totsika, analysed data from the UK Millennium Cohort Study, a longitudinal project following children born between 2000 and 2002 across seven waves of data collection spanning from 9 months to 17 years of age. Of the 10,228 participants with usable autism data, 160 had a parent-reported autism spectrum condition diagnosis recorded between the ages of 5 and 11. Parents also reported whether their child had been temporarily suspended or permanently excluded between ages 11 and 14, and the adolescents themselves completed the well-validated Strengths and Difficulties Questionnaire at 17, providing self-reported scores for both internalising difficulties—anxiety, depression and social withdrawal—and externalising difficulties.

The raw numbers were stark. By age 14, 21.9 percent of autistic children in the cohort had been excluded or suspended from school, compared with just 4.6 percent of their non-autistic peers. By 17, autistic adolescents reported significantly higher scores on both dimensions of mental health: internalising scores averaged 19.46 in the autism group versus 18.21 among peers, and externalising scores averaged 18.50 versus 17.34. After adjusting for a comprehensive set of confounders—sex, ethnicity, maternal age, socioeconomic deprivation, family structure, child health, prior behavioral difficulties, maternal psychological distress and parental school engagement—autism remained associated with 1.43 points higher internalising scores and 0.78 points higher externalising scores, and with more than double the odds of exclusion (an odds ratio of 2.32).

What distinguishes this study from earlier work is its statistical machinery. Simple associations between exclusion and poor mental health are notoriously difficult to interpret, because children who act out are more likely to be excluded in the first place, making the direction of cause and effect ambiguous. The research team confronted this head-on using causal mediation analysis under the counterfactual framework, employing the g-formula to estimate randomised interventional analogues of natural direct and indirect effects. This approach matters because the data contained intermediate confounders—prior externalising difficulties and maternal mental health—that are themselves influenced by autism and that also shape both exclusion and later outcomes. Simpler mediation methods would have produced biased estimates in this situation, so the g-computation procedure was essential for cleanly decomposing the total effect of autism into its direct and exclusion-mediated components.

The decomposition produced a clear and, in some ways, surprising result. For externalising symptoms, the total effect of autism was 0.69 points, of which 0.66 was a direct effect and 0.03 travelled through school exclusion—a small but statistically significant indirect pathway (95 percent confidence interval 0.004 to 0.06, p = 0.024). In other words, exclusion accounted for a modest slice of the association, estimated at roughly 4.9 percent, though the proportion itself was not statistically significant. For internalising symptoms, by contrast, the indirect effect was essentially zero (−0.0008, p = 0.936), with the entire association between autism and later anxiety and depression operating through the direct pathway. Exclusion, it seems, is a mechanism for behavioral deterioration specifically, not emotional deterioration generally.

The theoretical interpretation offered by the authors draws on the idea that schools function as protective environments, particularly for autistic young people who often depend heavily on routine, structure, predictable schedules and supportive adult supervision to regulate their behavior and emotions. When exclusion removes these scaffolds during adolescence—a developmental window already marked by heightened emotional reactivity and social pressure—the result may be a destabilising loss of exactly the supports that many autistic students rely on most. This aligns with Problem Behaviour Theory, which holds that adverse shifts in environmental context can interact with individual vulnerabilities, such as cognitive inflexibility, to elevate the risk of behavioral difficulties. Consistent with this account, research on residential mobility has shown that disrupting embedded routines and social networks predicts externalising problems more strongly than internalising ones, a pattern that mirrors the asymmetry observed here.

The findings also carry a subtler implication: exclusion does not simply reflect pre-existing behavioral problems but actively contributes to their development and escalation. Earlier studies in neurotypical populations, including work by Ford and colleagues and by Obsuth and colleagues, had already suggested that exclusion predicts later psychiatric difficulties even after accounting for prior vulnerabilities. The new study extends that logic to autistic adolescents, showing that exclusion operates as a pathway through which autism leads to externalising outcomes, rather than merely a consequence of them. A sensitivity analysis restricted to temporary suspensions only produced a similar-sized indirect effect that fell short of significance, possibly because fewer participants experienced only temporary exclusion, or because shorter removals from school are genuinely less damaging than permanent expulsion.

Why did exclusion fail to mediate internalising difficulties, when qualitative research has documented shame, low self-worth and social isolation among excluded autistic students? The authors offer several explanations. The direct pathway may reflect core features of autism itself, such as intolerance of uncertainty and sensory sensitivities, which generate emotional distress independently of school events. Measurement differences may also play a role: this study relied on adolescent self-report of internalising symptoms, whereas earlier work used parent reports, teacher reports, broader distress measures or retrospective interviews, each of which may capture different facets of emotional functioning. There is also the possibility of heterogeneity in individual experience—for some autistic adolescents facing chronic peer victimisation, which can affect a large majority of autistic students, exclusion may even offer temporary relief from bullying or the exhausting demands of camouflaging, potentially suppressing the group-level indirect effect.

The study is not without limitations, and the authors are candid about them. The autistic subsample of 160 participants is small, producing sparse data in some covariate strata and a positivity violation that the g-formula could only address through extrapolation, so the estimates warrant caution. Survey weights were not applied, limiting population representativeness, and residual confounding cannot be fully excluded despite the careful use of a directed acyclic graph to guide covariate selection. Missing data, ranging up to 34 percent across variables, were handled with multiple imputation by chained equations under a missing-at-random assumption, and the mediation models were run with 500 bootstrap replications to generate bias-corrected confidence intervals.

Even with those caveats, the practical message is pointed. Because exclusion is a modifiable environmental factor, the findings argue for preventative, autism-informed strategies that reduce reliance on exclusionary discipline altogether—better staff training, flexible policies, tailored support plans and structured reintegration programs such as low-stimulation learning hubs with one-to-one support. They also suggest that mental health outcomes in autism are not fixed by neurology alone but are shaped by social and institutional contexts that unfold over time. If a small but real share of behavioral difficulties in autistic adolescents traces back to the moment a school removes them from its community, then keeping that community intact, responsive and informed may be one of the most concrete levers available for improving autistic young people’s lives.

Subject of Research: The mediating role of school exclusion in the association between autism and adolescent internalising and externalising mental health outcomes

Article Title: School Exclusion as a Partial Mediator Between Autism and Adolescent Mental Health

Article References: School Exclusion as a Partial Mediator Between Autism and Adolescent Mental Health. (n.d.). https://doi.org/10.1007/s10803-026-07550-7

Image Credits: AI Generated

DOI: 10.1007/s10803-026-07550-7

Keywords: autism spectrum conditions, school exclusion, adolescent mental health, externalising difficulties, internalising difficulties, Millennium Cohort Study, causal mediation analysis, g-formula, Strengths and Difficulties Questionnaire, inclusive education, school discipline, UK cohort study

The research team, led by Abir Nagata of Hamamatsu University School of Medicine together with Rina Yamauchi of the National Center for Child Health and Development and colleagues at several other Japanese institutions, designed the study to move beyond broad statements about ‘good parenting’ and focus instead on concrete communication behaviors that parents report engaging in. Previous work had linked supportive parent–adolescent communication to better psychosocial outcomes, but the authors noted that evidence on specific practices during the COVID-19 pandemic was sparse. Their goal was to identify which, if any, of three commonly recommended practices — explaining matters in easy-to-understand words, empathizing with adolescents’ feelings, and holding family discussions — were associated with adolescents’ behavioral profiles during the pandemic’s first year.

To do this, the researchers conducted a nationwide, population-based cross-sectional survey in December 2020, using a stratified two-stage cluster sampling method designed to produce a sample representative of Japanese households. The analysis included 641 parent–adolescent pairs, with adolescents drawn from two school grades — fifth grade and eighth grade — capturing both late childhood and mid-adolescence. Each parent reported on how frequently they engaged in the three positive communication practices, while the adolescent in each pair completed the Strengths and Difficulties Questionnaire, a widely used and well-validated screening instrument that measures emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. From these responses, the team derived scores for total difficulties as well as separate internalizing difficulties, which reflect emotional distress turned inward, and externalizing difficulties, which manifest as outward behavioral problems such as acting out.

The survey revealed substantial variation in how often parents engaged in each practice. Just over 80 percent of parents — 80.3 percent — reported explaining things to their adolescent in easy-to-understand words, making this by far the most common practice. Empathizing with adolescents’ feelings was reported by 57.9 percent of parents, and 59.4 percent said they held family discussions. This variation mattered, because when the researchers ran weighted multivariable linear regression models — adjusting for demographic, household, and parental factors such as family structure and parental characteristics — the three practices showed distinct and statistically robust associations with adolescent behavioral outcomes. The use of weighted models and the population-based sampling framework strengthen the argument that these patterns reflect the broader Japanese population of families with adolescents rather than an unrepresentative convenience sample.

Explaining in easy-to-understand words was associated with lower total difficulties on the SDQ, with a regression coefficient of −1.79 and a 95 percent confidence interval spanning −3.56 to −0.03, a range that narrowly excludes zero. The same practice was also associated with lower internalizing difficulties, with a coefficient of −0.87 and a confidence interval of −1.73 to −0.01. In practical terms, adolescents whose parents took the trouble to translate complex information — pandemic rules, health risks, changes to daily routines — into language a young person could genuinely grasp tended to show fewer emotional and behavioral problems, particularly the anxiety- and mood-related difficulties that internalizing captures. During a period when adults themselves struggled to make sense of rapidly changing guidance, this capacity to communicate clearly appears to have given adolescents a firmer footing.

Empathizing with adolescents’ feelings told a somewhat different story. This practice was associated with lower total difficulties, with a coefficient of −1.69 and a confidence interval of −3.13 to −0.25, and notably with lower externalizing difficulties, with a coefficient of −1.02 and a confidence interval of −1.65 to −0.38. Externalizing problems — anger, defiance, acting out — are among the behaviors most commonly reported to spike during periods of household stress, and they often strain parent–child relationships further. The pattern observed here fits a familiar psychological account: when parents acknowledge and validate what an adolescent is feeling rather than dismissing or punishing emotional expression, the adolescent has less need to express distress through disruptive behavior. Empathy, in this framing, functions as an emotional regulator for the household as a whole.

But it was the third practice — family discussions — that produced the strongest and most consistent associations across every outcome the researchers measured. Adolescents whose parents engaged in family discussions showed lower total difficulties, with a coefficient of −2.40 and a 95 percent confidence interval of −3.62 to −1.18; lower internalizing difficulties, with a coefficient of −1.09 and a confidence interval of −1.79 to −0.39; lower externalizing difficulties, with a coefficient of −1.31 and a confidence interval of −1.98 to −0.63; and, uniquely among the three practices, higher prosocial behavior, with a coefficient of 1.08 and a confidence interval of 0.71 to 1.46. The prosocial finding is particularly striking. Prosocial behavior — the tendency to help, share, and cooperate with others — is not simply the absence of problems but a positive dimension of development that predicts later social competence and mental health. That family discussions were the only practice associated with boosting this positive trait suggests that structured opportunities for children to speak and be heard within the family may cultivate social skills that extend beyond the home.

The authors emphasize that their findings support promoting supportive parent–adolescent communication as a practical, low-cost approach to fostering adolescent well-being — both during periods of widespread disruption such as the pandemic and in ordinary family life. Unlike clinical interventions that require specialists, training, or significant expense, the three practices studied here are behaviors that most families can adopt with modest effort and no formal resources. Public health messaging during future crises, the study implies, might do well to include not just epidemiological guidance but concrete communication guidance for parents: explain what is happening in words your child can understand, acknowledge their feelings, and make space for the family to talk together regularly. The fact that these associations held even after adjusting for demographic and household factors suggests the practices carry independent weight rather than simply serving as proxies for affluent or otherwise advantaged homes.

As with all cross-sectional research, the study has limitations worth keeping in view. Because exposure and outcome were measured at the same point in time, the design cannot establish causality: it is possible that adolescents with fewer behavioral difficulties are simply easier to talk with, inviting more family discussion rather than benefiting from it. The data rely on parent-reported communication practices and adolescent-completed questionnaires, which introduces the possibility of reporting bias, and the survey captured a single moment — December 2020 — during a pandemic whose pressures evolved over time. The authors report no competing interests, and the study was conducted in accordance with the Declaration of Helsinki with written informed consent from parents and assent from adolescents, supported by grants from Japan’s Ministry of Health, Labour, and Welfare, the Japan Science and Technology Agency, and the Japan Society for the Promotion of Science, none of which influenced the design or interpretation. Even with these caveats, the consistency of the pattern — three distinct communication practices, each linked to better outcomes, with family discussions emerging as the most powerful of all — offers families and policymakers a rare commodity in adolescent mental health research: a simple, actionable finding grounded in a large, nationally representative sample. In a crisis that took so much ordinary life away from young people, the ordinary act of talking together at home appears to have given some of it back.

Subject of Research: Parental communication practices and adolescent behavioral health during the COVID-19 pandemic in Japan

Article Title: Association of parental communication practices with adolescent behavioral difficulties and prosocial behavior during the COVID-19 pandemic: a nationwide cross-sectional study in Japan

Article References: Nagata, A., Yamauchi, R., Ishitsuka, K., Morisaki, N., & Yamaoka, Y. (2026). Association of parental communication practices with adolescent behavioral difficulties and prosocial behavior during the COVID-19 pandemic: a nationwide cross-sectional study in Japan. BMC Public Health. https://doi.org/10.1186/s12889-026-29607-z

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29607-z

Keywords: parent–adolescent communication, COVID-19 pandemic, adolescent mental health, prosocial behavior, family discussions, Strengths and Difficulties Questionnaire, Japan, cross-sectional study, internalizing difficulties, externalizing difficulties, behavioral difficulties, health communication

Early childhood is a period of extraordinarily rapid development, and the habits formed during these years can echo across a lifetime. The World Health Organization has long emphasized that children under five need to sit less, play more, and sleep well to grow up healthy. Yet despite guidelines, public health initiatives, and childcare structures designed to promote movement, many German children under the age of six fail to reach recommended levels of physical activity, sedentary behavior, and sleep. Survey data from nearly 13,000 German children and adolescents revealed that only about a quarter achieved a minimum of 60 minutes of moderate-to-vigorous physical activity daily, a shortfall that researchers warn may undermine healthy lifestyle formation and long-term wellbeing.

The research team, led by Katarina Osojnicki of the University of Guelph and Christoph Buck of the Leibniz Institute for Prevention Research and Epidemiology in Bremen, set out to close a persistent gap in the literature. Most previous studies of the relationship between movement and mental health have focused on school-aged children and adolescents, and few investigations in the early years have relied on device-based measurement rather than parent reports, which are vulnerable to recall bias and social desirability effects. In a systematic review of studies on physical activity and sleep in young children, the authors note, only three had used objective measures of both behaviors in children between two and seven years of age.

The data came from a subsample of children enrolled in a Germany-wide daycare health promotion trial called JolinchenKids – Fit and Healthy in Daycare, originally launched by the health insurance company AOK. Baseline measurements were collected between September and December 2016, with one-year follow-up the following autumn. Children wore GENEActiv triaxial accelerometers taped to the left wrist for seven consecutive days and nights at 100 Hz sampling, while parents kept logbooks to record non-wear time. In total, 212 children aged two to six years provided valid accelerometer data at both time points; just over half were female, and roughly five percent were classified as overweight or obese.

Raw accelerometer signals were processed with the open-source GGIR software package in R, using the Euclidean Norm Minus One with Adjustment method and age-specific cut-points calibrated for preschoolers. Light physical activity was defined by accelerations of at least 61.8 milligravity, moderate-to-vigorous activity by 100.4 milligravity or more, and inactivity below that threshold served as a proxy for sedentary behavior. Sleep was detected with the van Hees algorithm, which identifies sustained periods when the arm remains within five degrees of horizontal for at least five minutes, allowing the researchers to derive total sleep time and sleep efficiency, the proportion of time in bed actually spent asleep.

The results paint a vivid picture of an active, well-rested cohort. At baseline, children spent an average of 418.7 minutes per day inactive, 112.7 minutes in light activity, and a striking 252.6 minutes in moderate-to-vigorous activity, comfortably exceeding the WHO recommendation of 60 daily minutes. They slept roughly eight hours per night with a sleep efficiency of about 80 percent. Mental health was assessed through the parent-completed Strengths and Difficulties Questionnaire, a validated screening tool for social, emotional, and behavioral difficulties, and average scores fell well within the normal range at both measurement points, declining slightly over the year.

Statistical modeling with linear mixed models, adjusted for the child’s age and sex, household income, parental education, migration background, and urbanity, revealed clear and consistent patterns. Moderate-to-vigorous and total physical activity were positively associated with both total sleep time and sleep efficiency, and all activity variables were positively associated with sedentary time, findings that held in both crude and adjusted analyses. In plain terms, the most vigorously active children also tended to sleep longer and better. Girls scored lower on the difficulties questionnaire, while children of parents with lower educational attainment or income scored higher, an important socioeconomic signal within the data.

Notably, however, the study found no association between physical activity and mental health scores in this age group. The authors point to a recent meta-analysis reporting similarly modest effects, suggesting that younger children generally enjoy high baseline levels of mental health, leaving little room for improvement detectable by broad screening instruments. It is also plausible that in early childhood, psychological wellbeing is shaped more powerfully by the home environment, relationships, and developmental processes than by activity duration and intensity alone. Subtle benefits to behavioral regulation or emotional competence may simply be invisible to a general-purpose questionnaire validated primarily for children aged four and older.

The findings sit within a complicated and sometimes contradictory literature. Some studies have reported no link between activity and sleep in preschoolers, others found that more active children took longer to fall asleep, and one analysis even observed an inverse relationship between high activity and total sleep duration. The researchers attribute these inconsistencies to differences in accelerometer placement, wear time, cut-point selection, and sleep algorithms, as well as the natural variability of young children’s routines, which are shaped by parental attitudes, weather, the built environment, screen time, bedtime rituals, and nutrition. They also acknowledge limitations of their own work: daytime naps could not be captured without sleep diaries, the sample skewed toward high-income households, and the analysis was underpowered and exploratory in nature.

Looking ahead, the team argues that tracking 24-hour movement behaviors with device-based measures over time is essential for understanding how activity, sedentary time, and sleep jointly influence development, and they call for future multi-component interventions that address all three behaviors simultaneously to test for synergistic benefits to mental health. Compositional data analysis, which treats the 24-hour day as a fixed budget of interdependent behaviors, may offer a more realistic statistical framework than examining each behavior in isolation. For now, the message for parents and educators is straightforward: keeping preschoolers vigorously active during the day appears to pay dividends at bedtime, in deeper and longer sleep during a stage of life when every hour of rest counts toward growing bodies and minds.

Subject of Research: Associations between device-measured physical activity, sedentary behavior, sleep, and mental health in German preschool children

Article Title: Exploring the associations between physical activity, sleep, sedentary behaviour, and mental health in young German children

Article References: Osojnicki, K., Brandes, B., Brandes, M., Zeeb, H., Vallis, L. A., & Buck, C. (2026). Exploring the associations between physical activity, sleep, sedentary behaviour, and mental health in young German children. Journal of Activity, Sedentary and Sleep Behaviors, 5(1), Article 12. https://doi.org/10.1186/s44167-026-00104-3

Image Credits: AI Generated

DOI: 10.1186/s44167-026-00104-3

Keywords: physical activity, sleep, sedentary behavior, mental health, preschool children, accelerometry, GGIR, Strengths and Difficulties Questionnaire, 24-hour movement behaviors, early childhood, Germany, public health

The study, carried out by Ikechukwu Frank Ogbonna of the Department of Pediatrics at the Federal Medical Centre, Umuahia, in Abia State, set out to answer a deceptively simple question: does the effect of worsening asthma severity on a child’s mental health depend on how well the asthma is controlled? Clinical guidelines, including those of the Global Initiative for Asthma, treat severity and control as related but distinct dimensions of the disease. Severity reflects the intrinsic intensity of the condition, while control describes how well symptoms and exacerbations are managed over time. The researchers hypothesized that these two dimensions might interact, jointly amplifying psychological risk in ways that neither alone could fully explain.

To test that hypothesis, the team conducted a cross-sectional analytical survey involving 101 children with asthma aged between 6 and 17 years, recruited from the hospital’s pediatric asthma clinic, alongside 101 age- and sex-matched controls drawn from the surrounding community. Matching the comparison group by age and sex was a deliberate methodological choice, since both variables are known to influence mental health scores in childhood and could otherwise confound the analysis. Mental health status in both groups was assessed using the Strengths and Difficulties Questionnaire, a widely validated screening instrument that generates a total difficulty score across emotional, conduct, hyperactivity, peer-relationship and prosocial domains.

Among the children with asthma, disease severity was classified using the Asthma Severity Scale, while the degree of symptom control was measured with the Asthma Control Test, a patient-reported instrument that captures daytime symptoms, nighttime awakenings, activity limitation and rescue medication use. The study’s central hypothesis was tested at a significance threshold of P less than 0.05, and the interaction between severity and control was examined using a multivariate logistic regression model, a statistical technique that allows researchers to estimate the independent contribution of each factor while holding the other constant.

The first and most striking result was that children with asthma scored significantly worse on mental health screening than their peers. The median total difficulty score of the asthma group was significantly higher than that of the matched controls, with a P value of 0.001. In practical terms, this means that even before any analysis of severity or control, the children attending the asthma clinic were already carrying a measurably heavier psychological burden than children of the same age and sex without the disease—a pattern consistent with a growing international literature linking chronic childhood illness to emotional and behavioral difficulties.

When the researchers turned to the interaction question, however, the answer was negative. There were no significant interaction effects of asthma severity and control on the mental health of the children with asthma. In the adjusted model, the relationship between mental health problems and asthma severity did not reach statistical significance, yielding an adjusted odds ratio of 8.13 with a 95 percent confidence interval of 0.85 to 101.17 and a P value of 0.10. The very wide confidence interval reflects the limited precision of the estimate in a sample of this size, but the key point is that severity, on its own, could not be shown to independently predict psychological difficulty once other factors were accounted for.

Asthma control told a different story. In the same adjusted model, only asthma control showed a significant effect on mental health: children with poorly controlled asthma had higher odds of developing mental health problems, with an adjusted odds ratio of 4.08, a 95 percent confidence interval of 1.03 to 16.13, and a P value of 0.04. In other words, a child whose asthma was poorly controlled faced roughly four times the odds of screening positive for psychological difficulties compared with a child whose disease was brought under command—regardless of how severe the underlying condition was classified to be.

The authors conclude that there is no interaction effect of asthma severity and control on the mental health of children with asthma, because mental health problems were associated only with poor asthma control, irrespective of severity. This distinction matters clinically. Severity is largely a fixed characteristic of the disease, determined by the intensity of the underlying inflammation and airway physiology, whereas control is the modifiable outcome of treatment adherence, inhaler technique, trigger avoidance and follow-up care. If poor control is the psychological culprit, then improving day-to-day asthma management may offer a direct route to protecting children’s mental health, even for those whose disease is intrinsically mild.

The practical recommendation that flows from the study is the integration of child mental health services into existing asthma management programs. In many low- and middle-income countries, including Nigeria, pediatric asthma clinics focus almost exclusively on respiratory outcomes—symptom scores, peak expiratory flow readings and exacerbation rates—while psychological screening is rarely performed. The findings from Umuahia suggest that this narrow focus may miss a substantial share of the disease burden. A child whose inhaler technique is poor and whose symptoms persist at night is not only at risk of a physical exacerbation; the same child is also at markedly elevated risk of emotional and behavioral problems that can undermine schooling, friendships and family life.

The study also carries lessons for research design. By recruiting matched controls and using validated instruments on both the respiratory and psychological sides, the work demonstrates that rigorous psychosocial measurement is feasible in a tertiary hospital setting in South-Eastern Nigeria, where such data have historically been scarce. The single-author design, funded entirely by the researcher’s personal contribution, underscores both the resourcefulness and the resource constraints of clinical research in the region. The study was approved by the Institutional Review Board and Health Research Ethics Committee of the Federal Medical Centre, Umuahia, in June 2021, with informed consent obtained from caregivers and assent from children aged eight and above, in line with the ethical principles of the Declaration of Helsinki.

For clinicians and policymakers, the message is straightforward but consequential. Screening for mental health problems should become a routine component of pediatric asthma follow-up, and interventions that improve asthma control—better adherence support, patient and caregiver education, and reliable access to controller medications—should be recognized as having potential psychological as well as respiratory benefits. Conversely, the finding that severity alone did not significantly predict mental health outcomes cautions against assuming that only children with severe disease need psychological attention. A child with mild asthma that is badly controlled may be more psychologically vulnerable than a child with severe asthma that is well managed. As childhood asthma continues to affect millions of families across Africa and beyond, studies like this one help redirect attention from what a disease is to how well it is lived with—and that shift, the evidence now suggests, could shape not only children’s lungs but their minds.

Subject of Research: The interaction of asthma severity and control on the mental health of children with asthma in South-Eastern Nigeria.

Article Title: Interaction effects of asthma severity and control on the mental health of children with asthma: findings from a South-Eastern Nigeria Tertiary Hospital

Article References: Ogbonna, I. F. (2026). Interaction effects of asthma severity and control on the mental health of children with asthma: findings from a South-Eastern Nigeria Tertiary Hospital. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07670-0

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07670-0

Keywords: asthma, asthma control, asthma severity, mental health, children, pediatrics, Nigeria, Strengths and Difficulties Questionnaire, Asthma Control Test, child health, chronic illness, BMC Pediatrics