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At least 19 recordsLinked to original sources
PubMed1999

Counseling families with a hearing-impaired child.

Parents are the linchpin of the family, and counseling for the young, newly diagnosed child with a hearing impairment needs to be directed at them. The operative rule for the counseling model described in this article is that feelings are neither good nor bad; they just are, and they need acknowledgment and acceptance, never judgment. Behavior can be judged as to whether or not it is productive, but parents never have to be responsible for how they feel. Armed with this nonjudgmental attitude toward emotions, the clinician can elicit them by empathetic listening.

Counseling↗
PubMed1988

Chronic intractable atopic eczema. Its occurrence as a physical sign of impaired parent-child relationships and psychologic developmental arrest: improvement through parent insight and education.

Atopic eczema of infancy and childhood responds readily and predictably to treatment; only a small percentage remains intractable. Lack of therapeutic response in a proportion of these patients can be attributed to dysfunctional parent-child relationships that lead to physical and emotional developmental arrest. Improvement in parent-child relationships following parental insight into their conflicted feelings permits acceptance of educational recommendations from the physician; it also allows normal development to be resumed and eczema to improve. Eight illustrative cases are reported in which aggressive dermatologic measures were combined with an approach that helped parents recognize conflict and provided education that permitted more appropriate behavioral limit setting. Rapid and sustained improvement in skin, emotional development, and social adjustment resulted.

Child↗
PubMed1995

Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children.

The present study examined factors that predicted favorable treatment outcomes among clinically referred conduct problem children (N = 105, ages 7-13) who received cognitive-behavioral treatment. Three domains (severity and breadth of child impairment, parent stress and psychopathology and family dysfunction) assessed at pretreatment were predicted to affect treatment outcome. The results only partially supported the prediction. Less dysfunction in each of the domains predicted who responded favorably to treatment on parent ratings of deviance and prosocial functioning but not on teacher ratings of these outcomes. The findings have implications for identifying youths who respond to available treatments. The results also underscore fundamental questions about the assessment of treatment effects and the criteria for evaluating outcome.

Adolescent↗
PubMed1989

Parental reaction to a child's hearing impairment.

Traditionally, parental reactions to a child's hearing loss have been discussed in terms of stages of the mourning process. Although this framework has been helpful in describing parent adjustment, it appears too simple. Parents react in complex ways to their children's disabilities; these complexities must be considered when working with families. A model of transition that accounts for individual differences is used to discuss the potential interaction among variables associated with the mourning process.

Attitude to Health↗
PubMed1996

Care-giver evaluation of anti-gastroesophageal reflux procedures in neurologically impaired children: what is the real-life outcome?

Although the pediatric surgical literature is replete with reports of the success of operations for gastroesophageal reflux, postoperative complications are being reported with increasing frequency for the neurologically impaired subpopulation. Because a large portion of a care-giver's life is involved in attending to a neurologically impaired child, parental satisfaction with the outcome of these operations should be an important consideration when the use of such procedures is contemplated. The purpose of the present study was to assess the impact of antireflux operations with respect to care-giver opinions regarding the procedure. The authors retrospectively reviewed 25 charts (of 13 girls and 12 boys; age range, 3 months to 18 years) and documented (through survey results) perceived child well-being, objective care requirements, and overall care-giver satisfaction with the procedure. Results indicate there was significant improvement in feeding indexes, care-giver perception of the child's comfort, and quality of life postoperatively. Moreover, there was significant improvement in the care-givers' attitudes regarding their child, including the level of frustration in caring for the child, and the parents' overall quality of life. Care-givers also believed that the operation's result was about or better than what they had expected. In conclusion, the study documents care-giver satisfaction with antireflux procedures. Postoperatively, child care is easier and the quality of time spent with the child is better. The impression of better quality of life postoperatively for a neurologically impaired child may be the greatest success in this sometimes frustrating endeavor.

Adolescent↗
PubMed1999

Parents' awareness and knowledge of the special needs of their hearing-impaired child.

We surveyed parents of school-aged hearing impaired children to investigate their awareness and knowledge of the special needs of their child, especially in the area of the usage of hearing aids and methods of communication. Questionnaires were distributed to parents of hearing impaired children at 13 special schools for the deaf in Malaysia. Out of 1,267 questionnaires given out, 787 (62.1%) were completed and returned. Results of the survey indicated the majority of parents (68.6%) suspected hearing loss late, that is after their child's first birthday, and there was a significant time lag before the suspicion was confirmed. Over 82.8% of the children were diagnosed only after 1 year of age, with 41.3% being diagnosed after 3 years of age. Hearing aids were fitted late (mean = 5.32 years; SD = 2.66). Hearing aid ownership was influenced by the factors of socio-economic level and ethnic group (p < 0.01) whereas knowledge of use and proper care of the aids was influenced by socio-economic level (p < 0.01). Communication methods were generally inappropriate with 41.3% of the mothers and 48.5% of the fathers reporting ignorance of Bahasa Malaysia Kod Tangan, the sign language that is commonly used by their children. The parents' choice of communication method was not significantly influenced by socio-economic level or ethnic group. The study revealed the present inadequate state of services available for the rehabilitation of children with congenital hearing impairment.

Adolescent↗
PubMed1997

Childhood sexual abuse, adolescent sexual behaviors and sexual revictimization.

OBJECTIVE: The aims of this study were to examine the extent to which exposure to childhood sexual abuse (CSA) was associated with increased rates of sexual risk taking behaviors and sexual revictimization during adolescence. METHOD: A birth cohort of 520 New Zealand born young women was studied at regular intervals from birth to the age of 18. At age 18 retrospective reports of CSA were obtained from sample members. Over the course of the 18 year study information was gathered on: (a) childhood, family, and related circumstances; and (b) the young women's history of sexual experiences from 14 to 18 years. RESULTS: Young women reporting CSA, and particularly severe CSA involving intercourse, had significantly higher rates of early onset consensual sexual activity, teenage pregnancy, multiple sexual partners, unprotected intercourse, sexually transmitted disease, and sexual assault after the age of 16. Logistic regression analyses suggested that the associations between CSA and sexual outcomes in adolescence arose by two routes. First, exposure to CSA was associated with a series of childhood and family factors including social disadvantage, family instability, impaired parent child relationships, and parental adjustment difficulties that were also associated with increased sexual vulnerability in adolescence. Second, there appeared to be a causal chain relationship between CSA and sexual experiences in which CSA was associated with early onset sexual activity which, in turn, led to heightened risks of other adverse outcomes in adolescence. CONCLUSIONS: The findings of this study suggest that those exposed to CSA have greater sexual vulnerability during adolescence. This appears to arise because: (a) the childhood and family factors that are associated with CSA are also associated with increased sexual risks during adolescence; and (b) exposure to CSA may encourage early onset sexual activity which places those exposed to CSA at greater sexual risk over the period of adolescence.

Adolescent↗
PubMed1994

Developmental outcomes of children of mothers dependent on heroin or heroin/methadone during pregnancy.

Developmental outcomes of infants of drug-dependent mothers (IDDM) who used heroin during preganncy, alone or in combination with methadone, were unfavorable compared with outcomes of infants of mothers who were not drug dependent or infants in the general population. Unfavorable items for IDDM were: gestational age and birth weight, physical growth, neurological development, intelligence, behavior, social competences and social state (foster care). Prenatal care with social support and methadone substitution were critical factors for IDDM. The IDDM in foster care appeared to exhibit even more unfavorable outcomes than those living with their biological parents.

Child↗
PubMed1994

Assessing children for the effects of sexual victimization.

In summary, the psychological assessment of sexually abused children is complicated significantly by the fact that there is no single syndrome that reflects the impact of sexual abuse (Kendall-Tackett, Williams, and Finkelhor, 1993). A number of generic measures of psychopathology in children continue to find large percentages of children relatively asymptomatic. This is due to the variability in impact of sexual abuse, but also reflects the need to develop abuse-specific outcome measures. Because we are discussing the evaluation of children, psychological assessment must be developmentally sensitive and reflect the context of the child (Stewart, Bussey, Goodman, and Saywitz, 1993). Consequently, information should be obtained not only from parents and children, but from the entire family. Unless an evaluation includes some abuse-specific measures and examines findings about the child in the context of the larger family environment, it is not likely to be valid. The interrelationship of abuse impact on parental perception and subsequent parental accuracy in reporting also must be examined in more detail. Not surprisingly, maternal reports of their sexually abused child's emotional states are strongly correlated with their own distress (Newberger, Geremy, Waternaux, and Newberger, 1993). This confound necessitates input from teachers or other objective observers of the child. The evaluation of sexually abused children should be theoretically driven. I strongly recommend assessing both the child and the parents with regard to attachment quality, difficulties with self-regulation, and an impaired sense of self. There are a number of measures pertinent to both parents and children across each of these domains. However, measures must be developed and validated that allow for parent, child, and teacher report in the areas of sexual behavior, sexual concerns, sexual meaning, body integrity, abuse-specific aspects of self (such as blame, shame, and dissociation), PTSD, abuse-specific fears, and family-related variables of rejection and role reversal. There is a developing literature that supports the need to assess each of these domains in a multimodal manner.

Adolescent↗
PubMed1994

Parental response to their child's hearing impairment.

The differential patterns of behaviour of hearing parents (30 married couples) who cope with the reality of parenting a hearing-impaired child were studied. Responses on the Questionnaire on Resources and Stress indicated no significant differences between mothers and fathers for pessimism, child characteristics, and physical incapacitation. Mothers obtained a significantly higher stress-response on their perception of difficulties for themselves, other family members, and the family as a whole. Parents with more education reported less stress than those with less education. Mothers perceived the emotional support they received from their spouses as insufficient and the amount of free time they had for themselves as inadequate.

Adaptation, Psychological↗
PubMed1996

Reported parental behaviour and adult affective symptoms. 1. Associations and moderating factors.

Associations between retrospective ratings of parental behaviour and adult affective symptoms were investigated in a British national sample. Symptom scores at ages 36 and 43 years showed low but significant correlations with care (negative) and control (positive), as measured by the Parental Bonding Instrument. Prevalence of high symptom scores was much greater in respondents with low care-high control (affectionless control) parents than in those with high care-low control parents, but there was no synergistic effect of combined care and control. Degree of affectionless control was progressively related to risk of depression. No significant gender differences were found in these associations. Findings could not be explained as spurious relationships resulting from association with other features of childhood adversity, and there was evidence that distorted recall arising from contemporaneous depressed mood was not responsible. Work is needed to establish the causal mechanisms underlying observed associations, including inter-relationships between parental style and other early adversity, and factors mediating or moderating the long-term of parental behaviour.

Adolescent↗
PubMed1996

Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse.

OBJECTIVE: To present accounts of the prevalence of childhood sexual abuse (CSA) and social, family, and related factors that are associated with increased risk of CSA, using data gathered during an 18-year longitudinal study of a New Zealand birth cohort. METHOD: A birth cohort of more than 1,000 children born in Christchurch (New Zealand) was studied prospectively to the age of 16 years. At age 18, retrospective reports of CSA were obtained. RESULTS: Of the cohort, 10.4% (17.3% of females and 3.4% of males) reported having experienced CSA before the age of 16 years. Rates of severe abusive experiences involving intercourse were lower: 5.6% of females and 1.4% of males reported abuse involving attempted or completed intercouse. Multivariate analyses that the risk of CSA was elevated among females (p < .0001), those exposed to high levels of marital conflict (p < .005), those reporting low parental attachment (p < .001), those reporting high levels of paternal overprotection (p < .005), and those with parents who reported alcoholism/alcohol problems (p < .05). The level of prediction of CSA from childhood and family factors was not sufficient to identify individuals at risk of CSA with any degree of accuracy. CONCLUSIONS: CSA was not an uncommon experience in this cohort. Those most likely to be exposed to CSA were girls reared in families in families characterized by high levels of marital conflict and impaired parenting and in families having parents with adjustment problems.

Adolescent↗
PubMed2002

[Children aged 0-3 years referred to child psychiatric department. A descriptive epidemiological study].

INTRODUCTION: In a Danish register study the incidence of children aged 0-3 years referred to child psychiatric services in Denmark increased by 30% during 1996-1998. The objective of this study was to further describe 0-3 year-old children referred to child psychiatric departments with a view to distribution of diagnoses, age, sex, and parental mental illness. MATERIAL AND METHODS: Children 0-3 years of age referred to child psychiatric departments in the County of Copenhagen in 1998 and 1999 were described on the basis of the clinical database and hospital records. RESULTS: A total of 159 children were admitted over a two-year period corresponding to an incidence of 0.4%. The ratio boys: girls were 1.3:1. However, with regard to pervasive developmental disorders boys dominated 6:1. Among girls, eating disorders were dominating in the youngest children with ratio girls: boys 5:2. Pervasive developmental disorders were the most common diagnoses in children aged 2-3 years, and the overall incidence of this diagnosis was 0.25 per 1000 per year. The most common diagnosis of the youngest children was Z-diagnoses, and most often these children had mentally ill parents. Attachment disorders, eating disorders, and adjustment reactions were common diagnoses in children with mentally ill parents, but more than half of these children did not have any diagnosis at all. DISCUSSION: The incidence of children with pervasive developmental disorder was found twice as high as observed in a register study covering referrals of children aged 0-3 years from all psychiatric departments in Denmark during 1996-1998. Reactive attachment disorder, eating and adjustment disorder, and Z-diagnosis are the most common diagnoses in the youngest children, and most often these children have mentally ill parents.

Child Development Disorders, Pervasive↗