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PubMed1996

Maternal attitudes and knowledge of child-rearing: associations with family and child outcomes.

A prospective, longitudinal study of a low birthweight, preterm cohort examined the effects of maternal knowledge of child development and concepts of child rearing on the quality of home environment and on child cognitive and behavioral outcomes. Measures of maternal knowledge at 12 months were found to be significantly associated with the quality of the home environment, the number of child behavior problems, and to a small but significant extent child Stanford-Binet IQ at 36 months. Maternal characteristics were associated with both maternal knowledge and maternal behavior. Child characteristics, including birthweight, were not associated with maternal knowledge or concepts of development for most of the cohort. Subgroup analyses by race/ethnicity revealed a similar pattern of results. However, a measure of neonatal health status was shown to be significantly associated with cognitive outcome in the African-American subgroup at 24 and 36 months.

Adult↗
PubMed1996

Language, communication, and transference in child analysis. II. Is child analysis really analysis?

Is child analysis really analysis? The child patient does not free associate, communicates to the analyst in large measure nonverbally, and operates from a different psychic organization than the adult. Nevertheless, child and adult analysis share the same basic principles, despite different techniques. Using clinical examples from Jeremy's analysis, I discuss how child analysis could benefit from greater use of analysis of transference and analysis of defense. I then discuss recent questions about the place of verbalization and interpretation in child analysis. This issue parallels polarities in adult theory concerning insight and relationship. Analysts should pay more attention to the similarities between child and adult analysis, so that information can be shared between both subspecialties.

Child Language↗
PubMed1981

Child psychiatry education in early child development: description of a training program.

Career training in child psychiatry, though provided from a developmental perspective, often lacks opportunity for directly observing normally developing infants. This paper describes a training program in which child psychiatry fellows, in collaboration with residents in pediatrics, follow a young couple and their first child from the third trimester of pregnancy through infancy and early childhood. Case illustrations and discussion of approximately 10 years' experience demonstrate how the program can enhance understanding of normal child development, development of the nuclear family, liaison between child psychiatrist and pediatrician and early detection of psychopathology in infants.

Adult↗
PubMed1991

Linking extreme marital discord, child rearing, and child behavior problems: evidence from battered women.

Relations between marital discord, parental behavior, and child behavior were investigated in a sample of 37 battered women and 37 comparison mothers and their children, aged 2-8 years. It was hypothesized that violent fathers would be more irritable but less involved, battered women more stressed and inconsistent in discipline, and both parents would reportedly use fewer positive and more negative child-rearing responses than comparison families. Based on maternal self-reports and mother-child observations, the only robust self-report difference between the groups of mothers were the level of stress and reports of inconsistency in parenting; in contrast, all of the expected differences were found between the mothers' reports of the 2 groups of fathers. Group effects on child behavior problems were also found. Children from violent families were reported to have more internalizing behavior problems, more difficult temperaments, and to be more aggressive than the comparison children. In the violent families, maternal stress and paternal irritability were the 2 significant predictors of child behavior problems, whereas in the comparison families only maternal stress was a reliable predictor.

Adult↗
PubMedDate not supplied

[The current family situation from the child psychiatrist's viewpoint and its effects on the personality development of the child].

The report discusses three aspects of the modern family situation: 1. Stability and continuity of the current family situation in today's West Germany: the woman is subject to contradictory expectations from the society which seems to contribute to the ambivalence of the mother-child relationship as well as to the tendency of misinterpreting the child as a substitute for own needs. 2. Child abuse as an extreme example for a distorted family life: Exaggerated and illusionary presumptions about the child and the intact family life lead to traumatising experiences in the family. 3. Family and chronic illness of a child: Without the involvement and commitment of the family the scientific programs in medicine will not lead to advanced medical treatment.

Child↗
PubMed1996

[Between family-oriented help and child protection--interventions within the scope of the child and youth aid law: an unsolvable dilemma?].

The new child care and protection legislation (German Social Aid) emphasises the support of the parents' responsibility for education. In addition, it includes separate provisions and opportunities for counseling and supporting young children and adolescents in crisis situations. Finally, it requires the Youth Welfare Office to inform the Guardianship Court if a legal decision is required to avert a threat of the child's welfare. In the process of making the complex precise and responsible decision on the prognosis for the child, the experts from the Youth Welfare Office mus decide weather to respond to a threat to the child with family-oriented support, of with intervention concerning parental care that will usually lead to the separation of the child from its social setting.

Adolescent↗
PubMed1996

Child spacing and two child policy in practice in rural Vietnam: cross sectional survey.

OBJECTIVE: To explore the reproductive pattern of women in rural Vietnam in relation to the existing family planning policies and laws. DESIGN: Cross sectional survey with question-naires on reproductive history. SETTING: Tien Hai, a district in Red River Delta area, where the population density is one of the highest in Vietnam. SUBJECTS: 1132 women who had at least one child under 5 years of age in April 1992. MAIN OUTCOME MEASURES: Birth spacing and probability of having a third child. RESULTS: The mean age at first birth was 22.2 years. The average spacing between the first and the second child was 2.6 years. Mothers with a lower educational level, farmers, and women belonging to the Catholic religion had shorter spacing between the first and second child and also a higher probability of having a third child. In addition, women who had no sons or who had lost a previous child were more likely to have a third child. CONCLUSION: Most families do not adhere to the official family planning policy, which was introduced in 1988, stipulating that each couple should have a maximum of two children with 3-5 years' spacing in between. More consideration should be given to family planning needs and perceptions of the population, supporting the woman to be in control of her fertility. This may imply improved contraceptive services and better consideration of sex issues and cultural differences as well as improved social support for elderly people.

Age Factors↗
PubMed1997

HOME inventory and NCATS: relation to mother and child behaviors during naturalistic observations. Home Observation for Measurement of the Environment. Nursing Child Assessment Teaching Scale.

The purpose of this study was to determine the relationships among the Nursing Child Assessment Teaching Scale (NCATS), the Home Observation for Measurement of the Environment (HOME) inventory, and interactive behaviors observed in the home for fifty-three 3-year-old, prematurely born children and their mothers. The total HOME score showed high internal consistency, with moderate subscale levels. NCATS total score showed high internal consistency, but low to moderate subscale consistency. Combining NCATS subscales into a mother subscale and child subscale improved internal consistency. The HOME and the NCATS mother subscale correlated with observed maternal behaviors, but the NCATS child subscale was unrelated to child behaviors. Relationships between observed behaviors and HOME scores did not differ for high- and low-education mothers or for Caucasians and African Americans, but only low-education mothers and African Americans exhibited correlations between NCATS scores and observed behaviors. These results show the HOME, NCATS, and naturalistic observations measure related, but not overlapping, aspects of the mother's contribution to her relationship with her child, but the NCATS child subscale should be used with caution with 3-year-olds.

Adult↗
PubMed2004

Child maltreatment and perceived family environment as risk factors for adult rape: is child sexual abuse the most salient experience?

OBJECTIVE: Child maltreatment and family functioning were examined as predictors of adult rape in a sample of 925 college women. METHOD: Information was obtained from retrospective self-report questionnaires. Child sexual abuse (CSA) was assessed with the Life Experiences Questionnaire, child emotional abuse (CEA) and physical abuse (CPA) were assessed with the Childhood Trauma Questionnaire, family functioning was assessed with the Family Environment Scale, and adult rape was assessed with the Sexual Experiences Survey. RESULTS: Approximately 17% of women reported a history of any form of child abuse: 8.9% reported CSA, 4.2% reported CPA, and 8.6% reported CEA. Fifteen percent of participants reported a history of rape since age 17. CSA and CEA, but not CPA, were related to adult rape. Experiencing multiple forms of child abuse increased the risk of adult rape. Logistic regression analyses indicated that CSA predicted adult rape (OR=1.9). Further, low levels of family cohesion predicted adult rape only in the absence of CEA (OR=1.2), and low levels of emotional expressiveness in the family predicted adult rape only in the presence of CEA (OR=1.4). CONCLUSIONS: Findings highlight the need to consider multiple forms of child abuse as well as family functioning in relation to the risk of adult sexual victimization. Findings suggest CSA is a risk factor for adult victimization independent of family functioning, and family dysfunction exerts an impact on rape only in relation to CEA.

Adult↗
PubMed2006

Prenatal methyl mercury exposure from fish consumption and child development: a review of evidence and perspectives from the Seychelles Child Development Study.

Evidence from an outbreak of methyl mercury (MeHg) poisoning in Iraq suggested that adverse effects of prenatal exposure on child development begin to appear at or above 10ppm measured in maternal hair. To test this hypothesis in a fish-eating population, we enrolled a cohort of 779 children (the main cohort) in the Seychelles Child Development Study (SCDS). The cohort was prenatally exposed to MeHg from maternal fish consumption, and the children started consuming fish products at about 1 year of age. Prenatal exposure was measured in maternal hair and recent postnatal exposure in the child's hair. The cohort has been examined six times over 11 years using extensive batteries of age-appropriate developmental tests. Analyses of a large number of developmental outcomes have identified frequent significant associations in the appropriate direction with numerous covariates known to affect child development, but only one adverse association between prenatal MeHg exposure and a developmental endpoint. Because such results could be ascribed to chance, there is no convincing evidence for an association between prenatal exposure and child development in this fish-eating population. Secondary analyses have generally supported the primary analyses, but more recently have suggested that latent or delayed adverse effects might be emerging at exposure above 10-12ppm as the children mature. This suggests that the association between prenatal exposure and child development may be more complex than originally believed. This paper reviews the SCDS main cohort study results and presents our current interpretations.

Animals↗
PubMed1998

The child abuse lottery--will the doctor suspect and report? Physician attitudes towards and reporting of suspected child abuse and neglect.

OBJECTIVE: To assess the responsiveness and attitudes of medical practitioners to the reporting of suspected child abuse or neglect. To determine whether characteristics of the medical practitioner (specialist or generalist, rural or urban based, age since graduation, gender, having children of their own) influenced the responsiveness to reporting. METHOD: A survey of all members of the Australian College of Pediatrics in Queensland (Australia) and pediatric registrars at a tertiary training hospital in Brisbane (n = 124) and a random sample of Queensland general practitioners (n = 100). The survey requested demographic details, responses to three case vignettes suggestive of possible physical abuse or neglect, and details of suspected child abuse or neglect reporting behavior. RESULTS: There were a wide range of responses to the case vignettes, but responses did not vary between specialties. Forty-three percent of all doctors had at some stage considered a case as suspected child abuse or neglect and decided not to report despite a legal mandate to do so. General practitioners were more cautious towards reporting. The reasons for not reporting were multiple but highlighted perceived problems in the services available for the child and family once a report was made. CONCLUSIONS: There is need for continuing education of medical practitioners regarding symptoms and signs of physical abuse and the role of doctors in the multidisciplinary management of child abuse. To some extent children's outcome when presenting to medical practitioners as a result of child abuse or neglect is no better than a lottery, dependent on which doctor they happen to see.

Adult↗
PubMed1998

Decisions and attitudes concerning child sexual abuse: does the gender of the perpetrator make a difference to child protection professionals?

OBJECTIVE: An investigation was conducted into whether child protection investigators, specifically social workers and the police, are as likely to take seriously a case of child sexual abuse if it had been perpetrated by a female rather than a male. Also, to examine whether the decisions relating to female-perpetrated abuse were predicted by participants' sex role perceptions of women and their attitudes concerning women's sexualized behavior towards children. METHOD: Participants advocated decisions in response to four hypothetical case of child sexual abuse in which the perpetrator was either male or female. The female perpetrators were then rated on femininity and masculinity characteristics and attitudes concerning women's sexualized behavior toward children were assessed. RESULTS: Following male--rather than female--perpetrated sexual abuse, case registration and imprisonment of the perpetrator was considered more appropriate by all participant groups; male social workers also considered social services involvement and investigation as more appropriate. A substantial number of decisions concerning female perpetrated abuse were predicted by participants' attitudes. CONCLUSION: While child protection professionals considered child sexual abuse perpetrated by females to be a serious issue warranting intervention, a number of advocated decisions suggested that they did not consider female-perpetrated abuse to be as serious as male-perpetrated abuse. The implication is that victims of sexual abuse perpetrated by a woman may be less likely to receive the protection afforded victims of male-perpetrated abuse. Furthermore, professionals' practices may be inadvertently perpetuating the view that female child sexual abuse is rare or less harmful than abuse carried out by males.

Adult↗
PubMed2004

The link between marital conflict and child adjustment: parent-child conflict and perceived attachments as mediators, potentiators, and mitigators of risk.

Parent-child conflict and perceived attachments to parents were examined as predictors, mediators, and moderators in the marital conflict-child adjustment connection in a sample of older children and young adolescents. After controlling for marital conflict, parent-child conflict predicted additional unique variance mainly for children's externalizing problems, and attachments to parents accounted for unique variance in children's externalizing and internalizing problems. Moderation effects illustrated that a higher level of parent-child conflict was a vulnerability factor, whereas a secure attachment was a protective factor, for behavior problems associated with marital conflict. Mediation effects were also evident and supported the proposition that parent-child conflict and attachment to parents mostly are partial mediators of effects in the marital conflict-child outcomes link. The findings illustrate the aggregation, potentiation, and amelioration of risk for adjustment problems associated with marital conflict, and highlight the importance of assessing multiple systems within the family.

Child↗
PubMed1998

Mother-child relationship, child fearfulness, and emerging attachment: a short-term longitudinal study.

Mother-child relationship (maternal responsiveness and shared affective positivity), observed in naturalistic interactions, and child fearfulness, assessed in standard procedures involving exposure to unfamiliar stimuli and with parental reports, were examined at 8-10 and 13-15 months in relation to child attachment in the Strange Situation at 13-15 months (N = 108). Mother-child relationship, at 13-15 months only, predicted child security versus insecurity but not the type of insecurity. In contrast, child fearfulness was unrelated to security versus insecurity but predicted the type of insecurity and arousal in the Strange Situation. Resistant and highly aroused children (B3-C2) were more fearful than avoidant and less aroused children (A1-B2). The analyses using discrete and continuous attachment scores produced converging results. The study informs the debate on early relationships, temperament, and attachment.

Affect↗
PubMed1995

Parent and staff behavior, previous child medical experience, and maternal anxiety as they relate to child procedural distress and coping.

Assessed the influence of adult in-session behavior and psychological variables on 77 preschool children's coping and distress during routine immunizations. Maternal anxiety was not related to the behavior of the parent, staff, or child. However, in-session behavior by one person was highly correlated with in-session behavior by the other people in the treatment room. The effects of parent and staff in-session behaviors, previous child medical experience, and maternal anxiety on child distress and coping was examined using hierarchical multiple regression procedures. Child coping was predicted by parent and staff behavior whereas child distress was predicted by parent behavior and by the level of the child's distress during previous medical and dental experiences. Implications for intervention and future research are discussed.

Adaptation, Psychological↗
PubMed1998

Child neurologist as expert witness: a report of the Ethics and Practice Committees of the Child Neurology Society.

A questionnaire was circulated to 1126 members of the Child Neurology Society to assess their opinions regarding the current medical-legal system and to determine the involvement of members of the Child Neurology Society as expert witnesses. Two-hundred eighty-five questionnaires were completed, corresponding to a response rate of 25.3%. Of the respondents, 52% were child neurologists in university-based, academic practices, whereas 32% were in private practice. Approximately 90% of the respondents reviewed cases for attorneys, and 37% of these reviewed five or more cases per year. The majority, 86%, had testified or been deposed as a treating physician, and 42% of the respondents had been the object of a medical liability lawsuit. Only 30% of the respondents believed that the current medical malpractice system was fair, and nearly 90% of the respondents indicated that the system should be reformed. Two thirds of the respondents indicated that there should be a mechanism for peer review and more than half believed that the Child Neurology Society should monitor the expert witness activities of its members. These results indicate that although child neurologists frequently participate as medical experts, the respondents have an unfavorable opinion of the current medical liability system. Based on the results of the questionnaire and the need for reform in the current system, monitoring of the expert witness activities of child neurologists should be considered.

Child↗
PubMed2006

[Influence of inclusive child day-care on nursery school teachers: a questionnaire survey of teachers with experience in inclusive child day-care in K City].

The purpose of this survey questionnaire is to investigate the factors influencing how nursery school teachers perceive inclusive child day-care in K City in order to qualify what support we can provide. The questionnaire was sent to nursery school teachers with experience in inclusive child day-care in K City. Three hundred seventeen teachers provided sufficient data for analysis. The results of this survey suggest that teachers perceive inclusive child day-care to lead up to self-development and the pleasure of child-caring. On the other hand, they feel a burden of inclusive child day-care, with teachers in their 40 s feeling a stronger burden than teachers in their 20 s. And teachers with experience in taking care of emotionally disturbed children or teachers with experience in taking care of hearing-impaired children feel a stronger burden than teachers without experience in taking care of them. The results of our survey also suggest that it is necessary for support systems to have special knowledge about disabled children and special ways of caring, and to decrease teachers' burden or dissatisfaction with inclusive child day-care.

Adult↗
PubMed1991

Child and family outreach services as an adjunct to child and adolescent mental health treatment.

Child and Family Outreach Services have been an important adjunct to urban community child and adolescent mental health treatment. The Child and Family Outreach Services Program was developed as an extension of a child and adolescent outpatient and child partial hospitalization program to provide a comprehensive continuum of treatment. The Child and Family Outreach Program generalizes and links traditional therapeutic services to the patient's and family's environment through in-home, in-school, and community intervention. The latter treatment model enables the mental health service provider comprehensively to treat and effect positive change with high-risk patients and their families. Outreach service involvement has increased treatment compliance and reduced out-of-home placements.

Adolescent↗