Depression in school-aged children: assessment & early intervention

A careful assessment of all of these factors will help nurse therapists who are also primary care providers develop a more holistic approach to treatment and, thus, increase treatment effectiveness. The three-pronged assessment approach discussed above is cost effective, safe, and indicated as a frontline measure to assess the risk for depression in children and their parents (particularly mothers), which can begin the process of "true" early intervention. I say "true" early intervention because in my role as an early intervention specialist, my first meeting with families usually occurs after a crucial incident requiring hospitalization of the child or the parent, or school failure, or both. My programs of intervention are hardly "early," although treatment is started relatively early in the life of the child. In the past few years, I have noticed that psychiatric-mental health advanced practice nurses, including myself, are increasingly working in some capacity in primary health centers, such as school-based clinics, churches, collaborative practices, and community health centers. It would be wonderful if we used these settings to identify risk for depression in children and begin preventive treatment (starting with teaching good sleep hygiene, a treatment in itself) to truly make early intervention a reality.     

Early intervention and identification: finding the family

Following the growth of early intervention programmes for very young children with special educational needs and their families in the 1960s and 1970s, there came a reflective period during which the efficacy of early intervention was questioned (Marfo and Kysela, 1985). This was followed in the 1990s by a challenge to narrow interpretations of effectiveness in favour of a more holistic analysis of the benefits of intervention programmes for the whole family (Buckley, 1994). It was suggested that more attention should be given to the quality of relationships being established between the child and family members and the context in which early intervention programmes are delivered. Families themselves have begun to assert this (Fitton, 1994; Hebden, 1985) and recent legislation, both in the UK and abroad, has underlined the need for strong interdisciplinary approaches to meet the diversity of special educational needs that exist in our child population. This multidisciplinary approach necessitates a change of focus. It recognises the parent, with their child, as central, implicit and fundamental to the early intervention team, and endorses their right to request appropriate access to services. The model also gives parents the freedom to expand the concept of the family to include extended family and friends (for example, Ballard, 1994). Other parent-empowering initiatives include parent-to-parent schemes (Hornby, 1989 and 1995) which increase the capacity of families to provide resources to other families. The days of professionals as experts have passed. This change in approach to families of children with special educational needs will challenge some professionals and demand a radical reappraisal of the structure of their role and their style of delivery of early intervention, but, if we want quality early intervention, such a review is fundamental to re-establishing its place as a valid and valuable resource to families.     

A different head? Parental agency and early intervention

This paper considers the agency and identity of parents of children with Down syndrome within early intervention. It draws upon semi‐structured, conversational interviews with nine parents and the reflections of one of the authors upon their experiences within early intervention programmes. It considers how representations of the deficit model permeate the participation of the parent in this process. It explores the multiple identities of the parents and links these to notions of parental participation within the current policy context of early intervention in England. The notion of parental agency is an implicit driver within the current early intervention programmes, yet it appears to be compromised by the nature of those programmes.     

ADAPTING THE MODEL: THERAPEUTIC WORK WITH CHILDREN FROM ARMY FAMILIES

This paper describes the development of a specialised therapeutic service for parents and their young children in an inner city social services family centre. The Under five's counselling service, based on the Tavistock Model, offers brief psychoanalytic interventions to parents who are worried about their young child's development e.g. crying, eating, persistent crying etc. The premise behind setting up such a service was to provide therapeutic intervention to the parent-child relationship at the earliest possible stage, preventing further ongoing difficulties. The paper draws upon observations and interventions with families I have seen in the first year the service was opened. Particular themes which emerged in the work with these families will be highlighted. In particular a link is made between early childhood difficulties and unresolved loss in the mother's lives. Furthermore, the impact of the service upon the rest of the social services family support services is commented upon.     

Horizons for Homeless Children: A comprehensive service model for homeless families

Horizons for Homeless Children is a not-for-profit organization that provides services to homeless children and their families. The organization has two primary programs: the Playspace programs, which are children's recreation and informal education places set up in shelters, and Community Children's Centers, which provide full-time early childhood education for preschool homeless children and on-site job training and GED classes for their parents. This article summarizes the operational experiences of the organization and examines the efficacy of the services it delivers.     

Family life education for day care programs serving the black community

The increase in working mothers has led to a growing demand for day care cross-culturally. Attitudes and opinions vary in regard to the necessity of parental involvement in these programs. However, to foster development of the “whole” child, meaningful and shared communication must exist between the parents of preschool children and their caretakers. The Family Life Education discussion ρoup is a form of social work intervention developed around the life tasks facing families and individuals. This article explores the use of such groups in conjunction with day care programs serving black children from low-income families.     

The Effects of the Healthy Families America Home Visitation Program on Parenting Attitudes and Practices and Child Social and Emotional Competence

This study examined the effects of a Healthy Families America (HFA) credentialed home visitation program on the parenting attitudes and practices of a sample of at-risk parents. It also examined the social and emotional competence of children whose parents successfully completed the program. The HFA model is an intensive early intervention program that targets at-risk families through home visitation services. Successful completion of the program is a process that takes between 3 and 5 years. Results indicate that, relative to the baseline, parents who completed the program showed significant positive change in parenting attitudes and practices. In addition, relative to other children their age, the children of families who successfully completed the program exhibited significantly higher levels of performance on measures of social and emotional competence.     

Continuity,Engagement and Integration: Early Intervention in Remote Australian Aboriginal Communities

Over the last decade there has been at best limited implementation of preventive interventions for vulnerable Aboriginal and Torres Strait Islander children and their families in remote communities of northern Australia despite growing involvement in the child protection system. This paper describes challenges for services seeking to engage parents who are subject to child protection measures. Brief case studies from an early intervention program in a remote community illustrate that responsiveness and continuity of engagement of parents over time is a necessary basis for an integrated approach to meeting the needs of vulnerable children and families in very remote settings.     

Identifying the needs of parents with learning disabilities: A review

Despite the success of some programmes in raising the parental competency of parents who have learning disabilities, many services are still providing only minimal support to such families, often following crisis intervention. Recent legislative changes within the UK have meant that statutory services are now required to adopt a preventative approach to children and families in need. A review of the literature reveals that children of learning-disabled parents are particularly vulnerable to abuse/neglect and removal from their natural family. This article addresses the difficulties that many clinicians currently experience in the early identification of parents who have learning disabilities. It also emphasizes the need for a systematic approach in the assessment of these parents prior to the implementation of parental teaching programmes.     

Are services to prevent foster care effective?

The prevention of foster care became an important issue for child welfare services during the 1970s. Two main types of prevention models have emerged: crisis intervention programs intended to prevent imminent placement and intensive service programs designed to avert those crisis situations that precipitate placement. A critical analysis of several project evaluations leads to the conclusion that neither model has been markedly successful. Low nominal project placement rates seem attributable to inability to predict placements and to client selection biases. From a strictly financial perspective, preventive services have been considerably more expensive than regular services, including temporary family foster care. Data from a new demonstration project in New Jersey illustrate various problems in providing and evaluating preventive services to families referred to protective service agencies. Implications of the findings for prevention programs and policies are discussed, and a new direction focused on truly early intervention with children and families is proposed.     

From Strength to Strength: A Manual for Professionals Who Facilitate Diverse Parent Groups

Abstract

This paper describes and analyses the program of Child Welfare Services (CWS) in Norway, using primary sources, aggregated data from Statistics Norway (SSB) and data from a recent study of 715 parents in contact with CWS. These data show that Norway's program orientation is on support, prevention, and early intervention, policies relevant to the emerging Australian policy context. Many of these services were beneficial for the general welfare of the children's family with over three- quarters of the children registered as clients in the Norwegian CWS receiving only supportive services during 2008. On the contrary, Australian systems primarily aim to identify and protect children under (possible) risk of abuse or neglect. Also, the survey data shows that families in contact with CWS are different to the general population in important ways, including family structure/demographics, socioeconomic characteristics, and physical and mental health. The results demonstrated that most of the parents agreed to contact CWS, and many were satisfied with the help they received. The data demonstrate that the Norwegian CWS respond to the welfare needs of vulnerable and marginalised families. Possible implications the Norwegian system might have for the children and parents who are accessing services are discussed.     

Engaging families through observation and reflection: a collaborative approach to making learning visible

Early childhood education is based on the assertion that young children are better prepared for school and life when educators and parents work together on their behalf. Family engagement is a central force in the education of young children, yet research suggests that parents and teachers often do not collaborate, and this can have an adverse impact on young children’s learning outcomes. This brief explores a new observation approach, referred to as Journey of Discoveries, to examine its influence on family engagement and its potential use as a collaborative tool for educators and parents to gauge children’s learning and development. Journey of Discoveries was tested with volunteer families and teachers in three select Early Head Start programs in California in 2014–2015. Responses from participants illustrated seven themes or potential pathways emerging from the approach that support family engagement, including: (a) teachers’ and parents’ celebration of children’s learning, (b) emotional responses to children’s learning, (c) importance of sharing learning as stories, (d) process of reflection, (e) holistic viewing of children’s learning, (f) the honoring of diverse voices, and (g) parents’ roles as leaders. The practical and policy implications of the Journey of Discoveries approach are also discussed.     

Reconstructing Popular Childhoods

SUMMARY. For the greater part of the nineteenth century experiences of popular childhoods were rooted in family economies to which children were expected to contribute. Family economies were diverse and family-controlled with children making a range of contributions depending on age and gender within local economies and subcultures. While older children, especially boys, entered paid employment if possible, younger children and girls undertook unpaid domestic tasks. Throughout the century there was a steady decline in opportunities for paid employment among children. Among families where wages and standards of living were rising, childhoods were gradually reconstructed as parents postponed their children's entry to paid employment. The rise in wages was very uneven and there was a growing crisis in the family economies of the poorest families, where children continued to see themselves as contributors despite shrinking child labour markets and the introduction of legislation to control them. Although schooling remained a costly item in domestic budgets, parents who could afford it sent their children to school and a period of often brief and irregular school attendance was a feature of the majority of childhoods by the 1860s. The introduction and enforcement of universal, compulsory school attendance after the Education Act 1870 greatly increased the costs of childhoods, causing a sudden large increment in the dependency of children upon their parents. This marked an acceptance of the legitimacy of intervention by the state in parent child relationships. With a settled period of more or less regular school attendance childhoods became more standardised and visible. Notions of popular childhoods were gradually reconstructed moving away from children as contributors towards children as consumers.     

Social skills training and parent education programs for aggressive preschoolers and their parents in South Korea

The purpose of this study was to develop and evaluate social skills training and parent education programs for aggressive young children and their parents in South Korea. Participants consisted of intervention group I, which included six children and their mothers in the social skills training and parent education programs; intervention group II, which included seven children and their mothers in the social skills training; and control group, which consisted of six children and their mothers. Pre-test-post-test control group design was used. Participants in both intervention groups reported a significant decrease in aggression and on improvement in pro-social behavior, emotional regulation, and social skills, while the control group reported an increase in aggressive behavior. Mothers in the intervention group I also reported an increase in warmth/acceptance. The findings indicate that both programs are highly effective in reducing aggressive behavior among young children and in fostering positive parenting behaviors.     

PARENTS' AND CHILDREN'S PERCEPTIONS OF A FAMILY SUPPORT INTERVENTION FOR CHILD BEHAVIOURAL PROBLEMS

The aim of this study was to establish the perceptions of children and their parents following a Family Support intervention for child behavioural and related difficulties. One hundred parents and 22 children aged 5–12 years participated in structured interviews, following the intervention. A framework approach to thematic content analysis was used. Themes, categories and subcategories were established. Parents discussed the usefulness of the intervention and the service in relation to therapeutic work (behavioural techniques and advice), support, practical help, and liaison with other agencies. They also identified service gaps. A number of factors were identified as responsible for improvement, both directly arising from and independently of the intervention. Despite their young age, children had good understanding of the interventions and their role in them, and expressed their wish for active involvement. The intervention was underpinned by a solution‐focused therapy model, combined with behavioural techniques. Families' perceptions indicate that they predominantly applied behavioural strategies, while some parents and children generated solutions in other areas of their lives. Family support has an important preventive role and should consist of an integral component of inter‐agency services for children with a broad range of behavioural and emotional difficulties and their families, and have close links with child mental health services.     

The distribution of a federal entitlement: The case of adoption assistance

Adoption assistance entitlements support children whose birth parents cannot care for them. The entitlements are meant to offset the extra cost to adoptive families of raising children whose early adverse experiences leave them with special needs. Unlike other Social Security Act programs, adoption assistance is not federally administered but is administered by states or localities. State-to-state variation in administration of this federal entitlement leads to unequal treatment of similar children. Moreover, although adoption assistance is an entitlement for children, payments made by many states are systematically correlated with the characteristics of adoptive families.     

Evaluation of what parents know about their children's drug use and how they perceive the most common family risk factors

Research on family risk factors for addictive behaviors in young people has not paid a great deal of attention to parents' knowledge of their children's addictive behaviors and of the family risk factors that affect such behaviors. The aim of this work is to compare knowledge about these two aspects in two groups of parents that differ regarding their children's declared drug use. The research was carried out with a sample of 309 schoolchildren and their families, divided into two groups: one of 154 families with children defined as non-Drug Users and another of 155 families with children defined as Drug Users. The results show that parents with children who consume drugs tend to strongly underestimate their children's use. Moreover, they overestimate the control they exercise over them and appear to be more familiarized with the use of drugs, if we compare them with parents of non-Drug Users. It is suggested that these results may be relevant for the planning of strategies that increase motivation in families with drug-risk children to participate in prevention programs.     

Mentoring At-Risk Latino Children and Their Parents: Impact on Social Skills and Problem Behaviors

The Family Mentoring Project, which provided approximately one year of mentoring for at-risk 10-year old Latino children and their parents, aimed to provide not only service but empirical evaluation of the program's impact. This University-community partnership offered individual mentoring, a group educational component for children and parents, and group social/recreational activities. A pre- and post-test analysis of 11 non-mentored and 20 mentored youth revealed positive gains on social skills for mentored children as reflected in self-ratings and mothers' ratings on the Social Skills Rating Scale (SSRS). Also based on the SSRS, mothers reported decreases in three problem behaviors for mentored children. In addition, by post-testing, the mentored children and their mothers compared very favorably with the SSRS standardized samples on both skills and problem behaviors. The findings suggest that bicultural competence may be fostered by programs that provide consistent and long-term mentoring, involve the children's families, include group educational components, and bring families and mentors together for social/recreational events.     

Strengthening Fragile Families Through Research and Practice

Almost one third of all children in the United States are born to unmarried parents. This figure is even higher among poor and minority populations. Because of their heightened risk for economic and social problems and family dissolution, disadvantaged, unmarried parents have been called “fragile families.” In 2002 the Bush administration announced its Healthy Marriage Initiative. Its purpose was to promote marriage, especially among low-income couples. In 2006 the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) allocated $150 million a year to marriage and fatherhood programs. However, the marriage education and research communities have paid little attention to fragile families. This article examines the findings from a groundbreaking new source of data called The Fragile Families and Child Well Being Study and the various programs now serving these families. The article concludes by suggesting empirically based interventions for assisting fragile families.     

Context,Diversity and Engagement: Early Intervention with Australian Aboriginal Families in Urban and Remote Contexts

This article describes challenges met implementing an early intervention programme for Aboriginal parents and their children in the NT (Northern Territory) of Australia in the context of efforts to remediate Aboriginal disadvantage. The intervention is an adaptation of an 8‐ to 10‐week, manualised parenting programme designed for four‐ to six‐year‐old children with behavioural difficulties. It was implemented for both Aboriginal and non‐Aboriginal children in urban Darwin and for Aboriginal children in three communities of the Tiwi Islands, near Darwin. Measured outcomes of the programme were positive overall with different outcomes by gender and Indigenous status. There were marked differences in retention of families from different socio‐cultural backgrounds in the programme, with a significant loss of participants from referral through commencement to six‐month follow‐up. This drop‐out was most marked for urban Aboriginal participants, despite highly flexible strategies of engagement and cultural adaptation of the approach pursued in each setting. The research provides lessons for the contextualisation of preventive interventions in diverse community settings and shows that systematic attention to cultural ‘fit’ of the intervention logic and cultural competence in engagement of disadvantaged families with multiple problems are fundamental to sustainability.