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PubMed1986

Mother-father-child interactions in families with a mentally retarded young child.

The functioning of families with a mentally retarded young child was studied by examining maternal, paternal, and child interactions. Forty Israeli families with retarded children and a developmentally matched sample were observed at home. In families with a retarded child, there was less frequent maternal behavior toward the retarded child, less frequent communicative behavior of the retarded child toward the parents, and more frequent spousal interchanges with regard to the child. Fathers of retarded children differed less from fathers of nonretarded children than did mothers. Results were discussed in relation to home-based intervention with retarded children.

Adult↗
PubMedDate not supplied

[Child custody restrictions according to sections 1666, 1666a BGB from the child and adolescent psychiatry viewpoint--legal and practical principles].

Within the clinical practice of child and adolescent psychiatry, the needs of the child are recurrently endangered by parents' expectations and/or behaviour. The task of the doctors, therapists and local authority social workers is to work together with the child's parents or guardians in order to assess their parental competence and if need be to contravene the latter with a care order. According to German law there are different possibilities of restricting the patients' rights or making a care order for children and adolescents up to the age of 18 years. The local authority social services department may make a care order especially according to the wishes of the child or the adolescent or when other circumstances necessitate it, and obtain parental consent afterwards (section 42 KJHG). The rights of the parents may be restricted in either single areas eg the place of the child's residence (section 1666 BGB) or completely (section 1666a BGB) in cooperation with the guardianship judge. The task of the judge is to decide within the legal context whether such a restriction of parental responsibility is necessary to protect the child.

Adolescent↗
PubMedDate not supplied

Childhood obsessive-compulsive disorder in the NIMH MECA study: parent versus child identification of cases. Methods for the Epidemiology of Child and Adolescent Mental Disorders.

Abstract-Because as many as 50% of obsessive-compulsive disorder (OCD) cases have had onset by age 15, interest in its detection in childhood is strong. Clinical experience indicates that children often try to keep their OCD secret and that parental report may give marked underestimates. The authors examined the prevalence of childhood OCD in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a four-site community survey which allowed comparison of both parent and child report of the child's OCD and related symptoms and disorders. OCD cases, based on structured interviews (DISC-2.3 with DSM-III-R criteria) with 1,285 caretaker-child pairs, were identified separately for parent and child (aged 9 through 17) informants from the MECA database. Cases were then examined for demographic characteristics, for obsessive-compulsive symptoms and other diagnoses reported in cases "missed" by one reporter, and for comorbid disorders. Of a total of 35 (2.7%) identified cases, four (0.3%) were identified by the parent and 32 (2.5%) were identified by the child, with only one overlapping case. In general, when OCD cases were "missed" by one reporter, that reporter did not substitute another disorder. These findings support clinical data that children with OCD often hide their illness and underscore the importance of child interviews for its detection.

Adolescent↗
PubMed2006

Home care of a child dying of a malignancy and parental awareness of a child's impending death.

In this population-based study, we found that parents who are aware that their child will die from a malignancy are more likely to care for their child at home during the child's last month of life compared to parents who are not aware. End-of-life home care was comparable to hospital care for satisfactory pain relief, access to pain relief and access to medications for other physical symptoms. Using an anonymous postal questionnaire, we obtained information from 449 parents in Sweden who had lost a child due to a malignancy between 1992 and 1997, 4 to 9 years before participating in our study. The prevalence of dying at home and being cared for at home during the last month of life was 23.7% when parents realized intellectually more than 1 month in advance that the child would die (versus 12% who did not), 28.7% for parents who sensed that the child was aware of his or her imminent death (versus 7.8% who did not sense this) and 21.9% for those who received information that the child's illness was incurable (versus 9.4% who did not receive the information). Prevalence of children's unrelieved pain was 11.6% for those receiving home care and 15.3% for those receiving care outside the home.

Adolescent↗
PubMedDate not supplied

Are child developmental outcomes related to before- and after-school care arrangements? Results from the NICHD study of early child care.

Data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care, a prospective, longitudinal study involving 933 children, were used to examine relations between cumulative participation in 5 types of out-of-school care (before- and after-school programs, extracurricular activities, sitters, fathers, and nonadult care) and child developmental outcomes in the latter part of first grade (approximately age 7 years). Children who consistently participated in extracurricular activities during kindergarten and first grade obtained higher standardized test scores than children who did not consistently participate in these activities, controlling for child and family factors and children's prior functioning. Participation in other types of out-of-school care was not associated with child functioning in first grade when background factors were controlled.

Child↗
PubMed1999

Methicillin-resistant Staphylococcus aureus carriage in a child care center following a case of disease. Toronto Child Care Center Study Group.

OBJECTIVES: To study the prevalence of methicillin sodium-resistant and methicillin-sensitive Staphylococcus aureus colonization in a child care center following the diagnosis of community-acquired methicillin-resistant S. aureus (MRSA) disease in a previously well 2 1/2-year-old attendee and to determine the optimal site of detection of S. aureus. DESIGN: Point prevalence survey and questionnaire administration. SETTING: A Toronto, Ontario, child care center. INTERVENTIONS: Parents were provided with general information. Consenting parents completed a questionnaire and permitted screening of their child at 1 or more of throat, nose, and perianal sites. Families of children who were culture positive for MRSA were offered screening and suppressive therapy. Nasal and perianal swabs were obtained from child care center staff and screened. RESULTS: Of 201 children, 164 (81.6%) had completed questionnaires and had undergone screening at 1 or more sites; 38 staff members (100%) completed questionnaires and were screened. A 26-month-old classroom contact with chronic dermatitis had MRSA detected only on perianal swab. Of 3 adult household contacts of the index case and 2 adult and 1 child contacts of the classroom contact, only the 7-year-old sibling of the classroom contact was positive for MRSA. By pulse-field gel electrophoresis, these isolates were identical and not related to any of the common strains circulating in regional health care institutions. Of 40 children with S. aureus (24.4%), 33 had cultures at 3 sites, of which the throat was more sensitive (22 [67%]) than the nostrils (15 [46%]) or perianal sites (8 [24%]). There was a tendency for higher carriage of S. aureus in children with certain risk factors, including personal hospitalization (prevalence ratio, 2.9; 95% confidence interval, 0.6-12.1), family member hospitalization (prevalence ratio, 2.0; 95% confidence interval, 0.6-6.6), and visiting the hospital emergency department (prevalence ratio, 3.2; 95% confidence interval, 0.7-14.5), all in the previous 6 months. CONCLUSIONS: To our knowledge, this is one of the first recognized cases of MRSA disease and apparent transmission in a child care center. Throat and perianal site screenings have a higher sensitivity in identifying children colonized with S. aureus than nasal culturing. Infection with MRSA should be suspected in disease unresponsive to standard antibiotic therapy.

Adolescent↗
PubMed1993

Young, scarred children and their mothers--a short-term investigation into the practical, psychological and social implications of thermal injury to the preschool child. Part II: implications for the child.

A short-term, prospective study, using both quantitative and qualitative methods, was designed to determine the practical, psychological and social implications of thermal injury resulting in scarring for children under 5 years of age, during the 6 months following the child's discharge from hospital. Mothers of 57 children (whose thermal injuries ranged from 1 to 41 per cent of body surface area and who all required skin grafting) were interviewed whilst the child was in hospital and at home, at 1 week, 2 months and 6 months following hospital discharge. From the mothers' descriptions, four categories of child behavioural response to thermal injury and hospitalization were identified. In the first week after discharge from the burns unit, 56 per cent (32/57) of children displayed minor or major disturbed behaviour, which had reduced to 19.3 per cent (11/57) by the 6-month interview. There were many reported physical and practical problems associated with the thermal injury and after-care. The MacGregor Deformity Scale was employed to assess the child's appearance. The child behaviour test scores (S. Jenkins et al. J. Child Psychol. Psychiatr. 1980; 21: 5; N. Richman et al. Pre-school to School-A Behavioural Study. 1982; Academic) demonstrated a similar progression of behavioural responses as the qualitative data, and, furthermore, indicated that the children under 2 years of age seemed to be affected for a more prolonged period.

Burns↗
PubMed2004

Mother-child discourse in two contexts: links with child temperament, attachment security, and socioemotional competence.

The goal of this study was to examine whether attachment security and child temperament predicted differences in the elaboration and emotional content of mother-child discourse in 2 contexts and whether those differences were related to a child's socioemotional development. Fifty-one preschool children and their mothers were videotaped reading a storybook and discussing the child's previous behavior. These conversations were coded for maternal elaboration and emotional content. Mothers also completed reports of child temperament, attachment security, and social behavior. Children completed measures of emotional understanding, behavioral internalization, and representations of relationships. The findings suggested that both aspects of mother-child discourse were related to attachment, temperament, and socioemotional competence, although the findings varied depending on the context of the discourse.

Adult↗
PubMed2006

G. Stanley Hall's contribution to science, practice and policy: The child study, parent education, and child welfare movements.

G. Stanley Hall influenced several social movements that had great implications for child wellbeing: the Child Study, Parent Education, and Child Welfare Movements. However, while Hall laid much of the foundation for the field of scientific child study and policy-relevant research, his legacy is virtually nonexistent. The current article reviews the life and contributions of G. Stanley Hall, and the dual role Hall played in history as a revered leader of the Child Study Movement and a controversial figure in the landscape of early child psychology.

Child↗
PubMed2001

A parent-child relationship scale derived from the child and adolescent psychiatric assessment (CAPA).

OBJECTIVE: To examine a measure of children's perception of their relationships with parents. METHOD: The Child and Adolescent Psychiatric Assessment (CAPA) was administered to 114 inpatients (aged 9-18 years) at a tertiary asthma center from 1991 to 1994. Ten items from the CAPA were developed as a separate scale, the Parent-Child Relationship Scale (PCRS). Some subjects (82) were given family and child assessments. RESULTS: The PCRS had good internal reliability (Cronbach alpha = .72). Construct validity was demonstrated by correlations with child and parent report on the Family Assessment Device (r= 0.46 and 0.35; p < .001) and high expressed emotion of the parent (t= 2.89; p < .01). Divergent validity may be evidenced by the fact that the PCRS was not significantly related to high emotional over-involvement. Predictive validity was shown by significant correlations with the total problem scores of parents' (r = 0.28; p < .01) and children's (r = 0.41; p < .001) Achenbach reports, and prediction of CAPA psychiatric diagnosis (OR = 5.83; 95% CI 1.80-22.63). CONCLUSION: The PCRS can potentially be used to assess the child's perspective of the parent-child relationship for research or clinical purposes and deserves further study.

Adolescent↗
PubMed2002

Child-care structure-->process-->outcome: direct and indirect effects of child-care quality on young children's development.

With datafrom the NICHD Study of Early Child Care, we used structural equation modeling to test paths from structural indicators of child-care quality, specifically caregiver training and child-staff ratio, through a process indicator to child outcomes. There were three main findings: (a) Quality of maternal caregiving was the strongest predictor of cognitive competence, as well as caregivers' ratings of social competence; (b) quality of nonmaternal caregiving was associated with cognitive competence and caregivers' ratings of social competence; and (c) there was a mediated path from both caregiver training and child-staff ratio through quality of nonmaternal caregiving to cognitive competence, as well as to caregivers' ratings of social competence, that was not accounted for entirely by family variables. These findings provide empirical support for policies that improve state regulations for caregiver training and child-staff ratios.

Caregivers↗
PubMed2006

Child outcome measures in the study of child care quality.

This article assesses whether there are methodological problems with child outcome measures that may contribute to the small associations between child care quality and child outcomes found in the literature. Outcome measures used in 65 studies of child care quality published between 1979 and December 2005 were examined, taking the previous review by Vandell and Wolfe (2000) as the starting point. Serious methodological problems were not pervasive for child outcome measures. However, methodological concerns were most prevalent among measures of socioemotional development. Furthermore, psychometric information on outcome measures was often missing from published reports, and health outcomes and approaches to learning were infrequently studied. Future research should address alignment issues between aspects of quality and the specific child outcomes chosen for study.

Child Day Care Centers↗
PubMed2006

Connecting child care quality to child outcomes: drawing policy lessons from nonexperimental data.

Effective early childhood intervention and child care policies should be based on an understanding of the effects of child care quality and type on child well-being. This article describes methods for securing unbiased estimates of these effects from nonexperimental data. It focuses on longitudinal studies like the one developed by the National Institute of Child Health and Human Development's Early Child Care Research Network. This article first describes bias problems that arise in analyses of nonexperimental data and then explains strategies for controlling for biases arising from parental selection of child care. Next, it comments on attrition in longitudinal studies and outlines some strategies for addressing possible attrition bias. Finally, it discusses the need to translate "effect sizes" derived from these studies into the kinds of cost and benefit information needed by policy makers.

Child↗
PubMed2004

An overview of child physical abuse: developing an integrated parent-child cognitive-behavioral treatment approach.

This article reviews and summarizes the extant literature regarding child physical abuse (CPA). Literature is summarized that describes the wide range of short- and long-term effects of CPA on children as well as the documented characteristics of parents/caregivers who engage in physically abusive parenting practices. Although the reviewed research documents that interventions geared only toward the parent have been found to produce significant improvements with respect to parenting abilities, parent-child interactions, and children's behavior problems, there is a paucity of research examining the efficacy of interventions developed specifically to target the child's emotional and behavioral difficulties. Based on the few studies that have shown emotional and behavioral gains for children who have participated in treatment, an integrated parent-child cognitive-behavioral therapy (CBT) approach is proposed here to address the complex issues presented by both parent and child in CPA cases. The direct participation of the child in treatment also may improve our ability to target posttraumatic stress disorder (PTSD), depressive symptoms as well as anger control and dysfunctional abuse attributions in the children themselves. Implications for practice, public policy, and research are also addressed.

Adult↗
PubMedDate not supplied

[The Croatian Society for Infant, Child and Adolescent Psychiatry: present state and proposals for improving the development of child and adolescent psychiatric services in Croatia].

The paper presents the current state of child and adolescent psychiatry in the Republic of Croatia. Thirty-seven psychiatrists practicing child and adolescent psychiatry in the entire Republic point to the lack of staff in this subspecialty profession. The subspecialty was approved by the Ministry of Health in 1994. The city of Zagreb satisfies the criteria of some European countries as regards the number of staff, but not as regards the organization of the service for child and adolescent psychiatry (e.g. lack of university hospital department as the base for medical teaching and further specialist training). In other and larger centers in the Republic the situation is well below the criteria achieved in this profession, particularly in the countries of the European Union and the USA. Still, psychiatric services in some towns tend to support the development of child and adolescent psychiatry in their environment by providing facilities and staff. There are still attempts, even in the health service itself, to overcome this lack of personnel and organization by transferring numerous cases from the domain of child and adolescent psychiatry to experts in other medical specialties or non-medical professionals, instead of improving the development of child and adolescent psychiatry. In some countries of the European Union and the USA it has already reached the monospecialty status, a tendency supported by the UEMS, which also makes efforts to coordinate programs of specialist training in the European countries. The described situation certainly has consequences in the of mental health care of children, adolescents and their families, because their treatment often begins only when a disorder has visibly developed. Its clinical manifestations can take very different forms.

Adolescent↗
PubMed1991

[Environment, public health and health education in Burkina-Faso (child-to-child program)].

The environmental factors influence the health status at individual and community level. This seems to be more important in tropical countries. This, in developing and specially in tropical countries, public health activities are more concerned with environmental factors. It is well known that in a community, mothers and children are more "at risk". Environmental factors influence child health status at different developmental stages. Several studies have proved the impact of mothers and community education on their health status. Thus mothers and adults education are important to improve child health. However, it became evident that a direct education of the child has also an impact. "Child to child program" is an active and participative educational approach. This report is about child activities related to environmental factors. These activities are promoted by our Association involving health workers, teachers, social workers in Burkina-Faso (west Africa).

Air Pollution↗
PubMed1989

[Child abuse and the lack of care. 2. An epidemiologic and social pediatric study of fatal child abuse and neglect in Denmark in 1970-1979].

The object of this investigation was to undertake an epidemiological, clinical and social pediatric study of cases of fatal child abuse and neglect in order to use the information in preventive work. A total of 38 children aged 0-13 years were registered in this retrospective study from all Danish forensic officers, pediatric departments, institutes of forensic medicine and the medico-legal council. At least 21% of the children had a history of failure to thrive and at least 21% had a chronic disease or handicap. At least 1/3 had been subjected to previous abuse and at least 11% of the siblings also. A minimum of 1/3 of the mothers and 18% of the fathers had a chronic physical or mental disease and most of the families came from the lower social groups. In nearly 1/3 of the cases, the crisis which precipitated the abuse was caused by the child's behaviour and, in nearly 1/3 of the cases, information was available about stressing factors in the adult concerned. The primary cause of death was head injury and, in order of frequency, intraabdominal injury, strangulation, drowning and neglect. Difficulties in the definition of fatal child abuse and neglect are the reasons for different incidences in various countries, but the present investigation showed an incidence of 0.8 child deaths from fatal child abuse per million inhabitants per year. In Denmark, at least four children die every year on account of child abuse.

Adolescent↗
PubMedDate not supplied

The influence of the family preservation model on child sexual abuse intervention strategies: changes in child welfare worker tasks.

There is no easy solution for child sexual abuse. Various innovations have been tried. Most are based on the belief that punishment without treatment is counterproductive in cases of intrafamilial child sexual abuse because it further disrupts the family. Many counties have developed strategies that divert offenders into treatment rather than prison. Professionals in those counties apparently believe that treatment with the threat of prosecution or imprisonment is faster, cheaper, less traumatic for the child, and more effective in reducing recidivism. Ideally, it will also help preserve families. To make such strategies work, child sexual abuse intervention professionals have adapted their activities through all phases of contact with the victim, offender, and the family. They must be collaborators, consultants, liaisons, counselors, and advocates. Finally, there is little research on the effectiveness of the innovative intervention strategies. To discern if those strategies are more effective than traditional approaches in reducing child sexual abuse, in helping the family to cope with the problem, and in minimizing system-induced trauma to the child, continued research is necessary.

Child↗