The role of child care in supporting the emotion regulatory needs of maltreated infants and toddlers

Infants and toddlers who experience physical abuse and/or neglect are at a severe risk for disruptions to emotion regulation. Recent prevention and treatment efforts have highlighted center-based child care as an important setting for providing support to the needs of these children, as child care centers are already an existing point of entry for reaching high-risk families. Guided by ecological theory, this review draws on the maltreatment and child care literatures to consider the opportunity for child care centers, specifically teacher-child interactions within the classroom, to support the unique regulatory needs of maltreated infants and toddlers. Existing research on the effects of child care for children facing other types of risk, as well as research with maltreated preschool children, provides a foundation for considering the role child care may play for infants and toddlers, whose emotion regulation skills are just emerging. More research is needed regarding teachers' roles in facilitating effective emotional experiences in the classroom that meet the unique needs of maltreated children. Additionally, early childhood teacher training that focuses on infant/toddler mental health and a trauma-informed perspective of care, as well as structuring child care centers as communities of support for high risk families, all may aid child care centers in better serving this vulnerable population.     

Lessons from introducing a livelihood project for unaccompanied children into an existing child protection programme in the Dadaab refugee camps in Kenya

Evidence shows that displacement, family separation and economic status are risk factors for child protection concerns and children's mental health, and that violence and economic status are risk factors for children's physical, emotional and social development. Family based care, community social support and economic strengthening have been shown to moderate such risk factors. This article explores the introduction of a livelihood project for unaccompanied children into an existing child protection programme in the Dadaab refugee camp complex in Kenya, with the primary objective of strengthening the household economy of foster families and improving the care of the fostered children. In this article the authors reflect on the programme's work in recognising and building on existing traditional clan-based family tracing and care mechanisms for unaccompanied and separated children, as well as the importance of understanding the particular needs of specific groups of children such as those without appropriate care. They discuss issues of insecurity and lack of funding affecting programme quality and programme monitoring, and discus challenges of project design. Consideration of how such challenges can impact on existing traditional care mechanisms is shared. The authors argue for greater acknowledgement and efforts to build on traditional child protection mechanisms within wider debates on child protection systems; greater understanding and consideration of the needs of unaccompanied children in particular contexts; better monitoring of the outcomes of child protection programmes on the children they serve; and adequate and sustained funding for child protection in emergencies.     

The Effectiveness of an Attachment-focused Treatment Model in a Therapeutic Preschool for Abused Children

Child maltreatment is associated with detrimental developmental effects. In view of the fact that child maltreatment typically occurs within the context of a caretaking relationship, attachment theory can give us insight into the nature of difficulties experienced by survivors. Therapeutic preschool has been found effective in addressing developmental problems in abused children. This study examines the effectiveness of an attachment-based therapeutic preschool for maltreated children. Means tests indicate that, at the time of discharge, the children being served had made significant overall developmental gains as well as significant gains in the personal–social and adaptive domains of development.     

Is Mothers’ Work Related to Childhood Weight Changes in the United States?

Taking family structure, father’s work intensity, and children’s developmental stages into consideration, this study examined the effect of a mother’s previous and contemporaneous work (employment and weekly work hours) on their children’s weight and their likelihood of having weight problems such as obesity, overweight, and underweight. Using data from the Early Childhood Longitudinal Study-Kindergarten Class of 1998–1999 (ECLS-K), this study adopted a fixed effect model and found that for 3rd to 5th graders, an increase in mothers’ previous work hours among two-parent families below the federal poverty level (FPL) increased the risk of the child being obese, while the current employment of single mothers below the FPL reduced the risk of the child being obese. Surprisingly, the employment of single mothers below the FPL increased the risk of the child being underweight, especially for 1st to 3rd graders.     

For adults only?:Confronting the implications of AIDS for children and young people

SUMMARY. Over the past year, Acquired Immune Deficiency Syndrome (AIDS) has gripped the public imagination and challenged both individuals and the ‘caring’ professions in terms of prevention and treatment. This article addresses some specific issues relating to children and our need to perceive AIDS as a legitimate concern for child health, education and social services in partnership with the voluntary sector and individual families. The author looks at caring for children with AIDS, the implications for those agencies and families and the need for accurate and honest health education for children     

Explaining heterogeneity in the child poverty rate among immigrant families: Differences by parental citizenship

Much of the debate about child poverty among immigrant families has centered on factors that place immigrant children at a high risk for poverty. What is missing in this debate and the literature is that children in immigrant families are economically heterogeneous and that children in naturalized families are doing as well as or better than children in native families in terms of economic status. To examine the heterogeneous economic status of children in immigrant families, this study compared children's poverty rates by parental nativity and citizenship status, decomposing demographic risk factors of child poverty. The results indicate that whereas lower parental education and employment status largely explain the relatively higher poverty rate among children in noncitizen families, higher parental education and employment rates and a lower rate of single parenthood explain why children in naturalized families have a lower rate of poverty than those in noncitizen families. Implications of these findings are discussed in detail.     

Kinship Care: Analysis of the Health and Well-Being of Grandfathers Raising Grandchildren Using the Grandparent Assessment Tool and the Medical Outcomes Trust SF-36 TM Health Survey

ABSTRACT

As more and more children are being separated from their biological parents because of AIDS, substance abuse, mental and physical illness, incarceration, and child abuse and neglect, child welfare agencies are relying more often on kinship care as a viable option for out-of-home placements. In many cases, kinship care falls on the grandparents. While keeping children within their families is generally viewed as preferable by child welfare agencies, it can be a burden on grandparent caregivers, who often exist on severely limited incomes and without much assistance or support from social service agencies. A research project was conducted which used both quantitative and qualitative data from research conducted by Jones and Gibbons (2000) on grandparent care, but this study focuses on the experiences of grandfathers who participated in the project and examines their outcomes in several different areas.     

Who Spanks Infants and Toddlers? Evidence from the Fragile Families and Child Well-Being Study

We use data from the Fragile Families and Child Well-Being Study (FFCW), a birth cohort study of children in 18 medium to large U.S. cities, to examine the prevalence and determinants of spanking among infants and toddlers (at mean age 14 months). Taking advantage of the large and diverse sample in FFCW, we conduct separate analyses for children of African American (N = 1710), Hispanic (N = 853), and white non-Hispanic (N = 812) mothers. Overall, about 15% of children are spanked at 12 months, with this share rising to 40% by 18 months and nearly 50% for children age 20 months or older. We find that there are marked differences in the use of spanking across the three racial/ethnic groups, with children of African American mothers more likely to be spanked and at a younger age. Moreover, while some predictors of spanking are seen across all three groups, others vary. Mothers who are young, who report more parental stress, or report their child has a more difficult temperament are more likely to spank across all three groups. However, being a boy increases the risk of spanking only within African American families. First-born children are at elevated risk of spanking to at least some extent in all groups, but much more so within Hispanic families. In addition, maternal employment is associated with a greater likelihood of spanking in Hispanic families.Although spanking at these young ages is not necessarily indicative of maltreatment, it may be a marker for families who are at elevated risk of maltreatment. As such, our findings, by highlighting some risk factors that are common across groups as well as some that are more important for particular groups, may have implications for child abuse prevention.     

The Impact of Multiple Risk Factors on Young Children's Cognitive and Behavioural Development

The paper maps out 10 risk factors measuring deficits in parent–child interaction, family–child interaction and the home environment. The prevalence of risk factor combinations is quantified using the UK Millennium Cohort Study data. In 2001, 28 per cent of families with young children were facing two or more risk factors at age 9–10 months old. Each combination of multiple risk factors accounted for a very small proportion of all MCS families. Specific risk factors were associated with particular developmental outcomes at age 5 and with changes from age 3 to age 5, but all leading to worse outcomes. The great diversity of risk‐factor combinations and their very small prevalence make the tasks of identifying such families and defining eligibility for support very difficult for policy‐makers. These results support the large body of policy literature advocating early intervention to improve children's development.     

Of Pots of Gold and Pots of Glue: Society's Maltreatment of America's Poorest Children and Their Families

This article reports data from two qualitative studies with child welfare lowyers, judges, masters, and social workers (N = 59). Two themes emerged: the first is that child welfare involvement occurs within a broader societal context, and that child protective services and courts are called to address a broad range of concerns with severely inadequate resources. Participants saw that the paucity of resources as evidence of lack of societal concern for poor children and their families. They attribute lack of concern to ignorance of the circumstances faced by these vulnerable populations and to disregard due to their lack of political power.     

Child development in HIV-positive and HIV-affected children in South Africa and Malawi—What role for community organisations?

There is evidence that children who are HIV positive (HIV +) are at risk for poor developmental outcomes. The aims of this study were to use developmental screening tools to measure outcomes of children affected by HIV/AIDS attending community-based organisations (CBO) and to determine what types of CBO provision these children were receiving. In a cross-sectional study, we interviewed 979 children and their carers (4 to 13 years) at 28 randomly selected CBOs funded by 11 major donors in South Africa and Malawi. Developmental outcomes were assessed using the Ten Questions childhood disability screening tool and the Strengths and Difficulties Questionnaire. Health-related quality of life was measured using the Paediatric Quality of Life Scale. Overall, 13.8% (n = 135) were HIV +. HIV + children were more likely to have developmental difficulties and lower health and educational quality of life, controlling for a range of factors. Developmental difficulties and poorer quality of life were predicted by being HIV +, living in South Africa, not attending school regularly, poor housing conditions and living with a sick family member. HIV + children tended to have been enrolled in CBO programmes for a longer period compared to other children but reported lower rates of contact. A greater proportion of HIV + children received medical services, psychosocial interventions and emotional support, compared to HIV − children. However, fewer HIV + children were enrolled in play groups, early childhood intervention programmes and educational programmes. Screening for developmental problems using short tools is possible in community settings in order to identify children with developmental difficulties and plan services for children infected with and affected by HIV. This study highlights the important role of CBOs to intervene to improve child development outcomes. The delivery of evidence-based services that target child development outcomes will enable HIV-infected children to meet their developmental potential and promote their participation in their communities.     

Gambling behaviours and associated familial influences among 9-year old Pacific children in New Zealand

There is a paucity of research investigating child gambling, particularly studies that do not use retrospective designs. The presented findings provide cross-sectional data of the gambling behaviours of 874 9-year old Pacific children from a birth cohort study (recruited from one hospital) investigating health, developmental and social outcomes for Pacific children and their families in New Zealand. Structured interviews were administered to participants (mothers and children), face to face, in their homes (mothers) or school (children). Child gambling behaviours and associations with some maternal behaviours were investigated; five gambling participation questions were included in the child interview. Almost all child respondents (96%) reported having played card games with family or friends and 60% reported participation in housie (bingo), although only 27% reported having bet with money. Associations were noted between child gambling and household deprivation, and effectiveness of parental monitoring. There was no association between children's gambling and mothers' gambling. This is the first research to examine gambling in Pacific children at 9 years of age within a familial context. It will allow exploration of links between parental gambling and child development of gambling behaviours, as well as risk and protective factors for problem gambling at future data collection phases of the study.     

The experiences of children living with and caring for parents with mental illness

This research provides a three‐way perspective on the experiences and needs of children who are living with and caring for parents with severe and enduring mental illness. The views of children, parents and key workers were sought in order to provide deeper insight into the needs of families and the nature of interfamilial relationships, as well as the relationships between service users and providers. Child protection and medical research has long proposed a link between parental mental illness and the risk to children of abuse, neglect and developmental delay. The inevitability of risk associations is challenged by the research described here and outcomes for children of caring for parents with mental illness are discussed not simply in terms of risk to children but more broadly in respect of, for example, positive parent–child relationships. Copyright © 2006 John Wiley & Sons, Ltd.     

The reconstruction of childhood–implications for theory and practice

First, the article deals with selected aspects of change that have framed the lives of contemporary families and children in Scandinavia: urbanization; secularization and norm-pluralism; changes in work-conditions; ideologies about the role of mothers; structural changes in family patterns; and the modern professionalization of care. Second, how change induces a crisis in the grand developmental approach within child psychology is investigated. It is argued that any a priori universal and non-contextual derived type of knowledge about development fails to grasp what is going on within families and in care and socialization in rapidly changing cultures such as Scandinavia and other Western European countries. An alternative paradigm is presented that should make us better able to understand development as embedded in culture and time. Third, some new challenges for educating the skilled practitioner are focused upon. Here reflective competence will be addressed: expertise as an ‘eternal process of inquiry; the ability to use multi-based and often conflicting knowledge about families and children in order to solve problems in everyday situations; the strengthened emphasis on the practitioner-as-person and the ability to use practical and reflected knowledge in different contexts. Finally, new bases of scientific knowledge are suggested for use in the future education of practitioners.     

Patterns of child maltreatment referrals among Asian and Pacific Islander families

Much of the available data on Asian American families who become involved with the child welfare system relies on global ethnic categories, such as the category Asian/Pacific Islander. To explore the diversity of experience that is hidden by such categories, this article analyzes two years of child maltreatment referrals for Asian and Pacific Island families in Washington state. The study findings show that considerable variation exists within the Asian and Pacific Islander population with regard to child protection referrals. Although Asian Americans as a whole were less likely to be referred to child protective services than other groups, the within group picture that these data capture is considerably more complex. Some Asian/Pacific Islander ethnic groups, particularly those which have experienced higher levels of social and economic stress, were more at risk of child welfare involvement than other groups. Such findings underscore the need for child welfare policies and practice that are sensitive to the considerable variability within the Asian/Pacific Islander community.     

Chapter 10: Issues in HIV/AIDS Service Delivery to High Risk Youth

Homeless and runaway youth engage in behavior that puts them at risk for infection with HIV, the virus that causes AIDS. Prevalence of HIV disease in homeless and runaway youth is higher than it is among other adolescents. In addition, homeless and runaway youth are often forced to engage in sex as a means of survival. Although they engage in high risk behavior, AIDS education programs have neglected them as a target group for education. To some extent, they have been included in other more general categories of persons with AIDS risk behaviors, such as men who have sex with men or intravenous drug users. However, the number of adolescents receiving age-specific HIV/AIDS information is far below the number infected (Hein et al., 1992). Often high risk youth are disenfranchised, having been forced from home by their families after disclosing their gay or lesbian identities. Lacking a political voice and having no spokesperson, they represent a group with complex unmet needs. These youth typically have immediate needs for food, shelter, and clothing. In addition, they often need medical management, mental health and drug counseling, crisis management, and HIV/AIDS information. These needs are often overwhelming to the agencies that serve youth. This article examines the barriers and issues that exist in providing services to high risk youth. Then, suggsetions for removing those barriers by empowering both service providers and youth are offered. Some of the suggestions are based upon the authors' own experience in providing HIV/AIDS in-service training to service providers to high risk youth. The article makes recommendations for policy on youth and HIV/AIDS.     

Cocaine-Exposed Toddler-Caregiver Dyads During Free Play at 24 Months

Some women continue to use cocaine during pregnancy, placing their fetus at risk for developmental problems. While gross problems are not evident after controlling for experimental flaws, subtle effects continue to be found. Social interactions of cocaine-exposed and nonexposed toddlers and their caregivers were assessed during a Free Play test to determine if psychobehavioral deficits were clinically observable. Risk factors were evaluated to assess whether the child’s socioemotional-behavioral behaviors were related to exposure and/or interactions with caregivers or the environment. Twenty-four-month-old cocaine-exposed and nonexposed toddlers were evaluated with the Child Behavior Check List while they played with their caregivers. Caregivers’ vocalizations were scored as contingent pairs if they occurred within 3 seconds of the child’s. The proportion of pairs was compared by group. Quality of caregivers’ vocalizations was rated as positive or negative based on approval, encouragement, and criticism. General linear model analyses indicate that cocaine-exposed children showed more dysfunctional behaviors than noncocaine-exposed children. Deficits increased when income and number of dependents were included. Caregivers in the drug group emitted fewer vocalizations during play before receiving a toy, indicating fewer opportunities for learning. No effect of quality of caregiver communication or gender by cocaine exposure interaction emerged. Cocaine exposure predicts poor developmental outcomes, but the toddler-caregiver relationship and reduced access to resources are additional risks that had previously been attributed to cocaine exposure. Early intervention services are needed to reduce the impact of low income, increase preschool readiness, and optimize functioning of these fragile families.     

Examining risk,strengths, and functioning of foster families: Implications for strengths-based practice

ABSTRACT

Foster families provide safe and stable homes for children and youth who are removed from their homes due to maltreatment. Despite the stressors associated with bringing children in and out of a family’s home, many maintain healthy family functioning and continue fostering for many years serving an essential function in the child welfare system. This study sought to understand the factors that explained higher levels of family functioning within foster families. Collaborating with one statewide public child welfare agency, 681 licensed foster parents participated in an online survey that examined the association between family functioning with family strengths and risk factors. Findings from this study can inform strengths-based practice including training, assessment, and interventions for new and existing foster families to strengthen families and improve the well-being of children and youth in their care.     

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.     

Child maltreatment in China: An ecological review of the literature

This article presents findings of a systematic review of empirical studies on child maltreatment in China that were published in either English or Chinese. The review uses Bronfenbrenner's ecological systems theory as a lens to examine risk and protective factors of child maltreatment within micro-, meso-, exo-, macro-, and chrono- system levels. A search of 5 electronic bibliographic databases and websites identified 24 outcome studies on child maltreatment in China, which included studies that examined physical/emotional/sexual abuse, and neglect. The most direct influences of child maltreatment in the micro-level system include the parent-child relationship and intergenerational transmission of abuse. At the macro-system level, maltreatment is explained by cultural values such as filial piety and familism. In essence, different factors are found within the various system levels that indicate the complexities of the factors that influence child maltreatment. Throughout the article, we highlight the need to understand the cultural dynamics, values, and mores of Chinese families. The discussion includes practical suggestions and implications for intervention with children, parents, and grandparents that school teachers, social workers, policy makers, and researchers can utilize.