Kidney-transplanted children and their families: A social worker's experience

Abstract

This paper describes approaches to the problems of families with children who undergo kidney transplanation and the emotional stess experienced at different phases of assessment and treatment.

Thirty-seven families were studied. The author describes family-oriented interviews in preparation for transplantation, supportive conferences, counselling and other forms of socioeconomic support.

Previous literature shows that where the family has been given sufficient time for emotional preparation and adaptation mere are fewer problems. I have compiled information given by the patients after transplantation concerning social contact, isolation, school problems, dependency, emancipation, growth inhibition, and discrepancy between physical and psychological development. These problems seem to be most pronounced around secondary school-age/puberty.     

Parental spanking and subsequent risk for child aggression in father-involved families of young children

This study examined separate and combined maternal and paternal use of spanking with children at age 3 and children's subsequent aggressive behavior at age 5. The sample was derived from a birth cohort study and included families (n = 923) in which both parents lived with the child at age 3. In this sample, 44% of 3-year-olds were spanked 2 times or more in the past month by either parent or both parents. In separate analyses, being spanked more than twice in the prior month at age 3, by either mother or father, was associated with increased child aggression at 5 years. In combined analyses, there was a dose–response association; the greatest risk for child aggression was reported when both parents spanked more than twice in the prior month (adjusted odds ratio: 2.01; [confidence interval: 1.03–3.94]). Violence prevention initiatives should target and engage mothers and fathers in anticipatory guidance efforts aimed at increasing the use of effective and non-aggressive child discipline techniques and reducing the use of spanking.     

Data culture as a change agent for organizations serving families and children experiencing homelessness

Over the past decade there have been considerable developments in the use of data in the field of child and family homelessness. The development of high-quality data collection processes—including Housing Management Information Systems (HMIS), community point-in-time counts, and school district data and evaluation infrastructure—has given nonprofit and social sector leaders unprecedented access to client-level data. However, it remains a challenge for nonprofits and community-based organizations to engage in work with families experiencing homelessness and demonstrate meaningful impact across a variety of outcomes. In this policy brief, the authors discuss (1) challenges facing the field of child and family homelessness with respect to data use, (2) recent advancements in the use of data, and (3) strategies to create an organizational culture of data that makes use of recent advancements in data use and addresses current challenges facing the field. The brief makes the argument that fostering a data culture at the organizational level has the capacity to operate as an organizational change agent that improves programs.     

Supporting families: Outcomes of placement in voluntary out-of-home care for children and young people with disabilities and their families

Parents caring for children and young people with disabilities typically have extensive additional demands on their time and resources. This added pressure can significantly impact well-being and mental health. In extreme circumstances, parents may seek an out-of-home placement for their child. Previous research has looked into factors that influence decisions for families to place their child into out-of-home care but little is known about outcomes for these young people and their families. The Supporting Families study aimed to explore the impact of a voluntary out-of-home placement on young people with disabilities, and consequences for their families. Fourteen parents/carers, twenty six case managers, six accommodation services' managers, and four young people with disabilities participated in face-to-face and telephone interviews and focus groups. Participants reported a range of outcomes for young people in care. Positive outcomes included increased levels of respect for themselves and others, an improvement in independent living skills, and reductions in challenging behaviours. Negative outcomes centred on their experiences of grief, loss and rejection, as well as behavioural problems. Positive and negative outcomes were also found for families. For many parents/carers there was a reduction in perceived stress and caring load, as well as improved mental health and wellbeing for them and the child's siblings. However, parents/carers often experienced ongoing feelings of guilt, grief and loss. The study adds to knowledge about outcomes of being in voluntary out-of-home care for this small but vulnerable group of young people in care and their families.     

Investments in young children among low-income families

This article examines low-income parents’ monetary investments in their young children, asking how low-income families are able to afford spending on children. We investigate parental spending on child care and on goods in the home that may provide enrichment for young children. We find little evidence that households make spending trade-offs for either type of good. Instead, our results suggest that low-income households that can afford child care may be poor only temporarily and that they spend primarily when they are unable to avoid doing so because of family work patterns. For enrichment goods, parental education is a stronger predictor of spending.     

Working with neglected children and their families

Child neglect has proved a particularly difficult area for social work to address. In the first part of the paper a number of reasons for this are discussed. We go on to suggest that chronic child neglect characteristically involves the breakdown or absence of a relationship of care. Therefore, the social work response needs to include a focus on the relationship difficulties between parent and child which manifest as either an unwillingness or inability on the part of the primary carer to offer reliable, adequate care, and on broader relationship difficulties within the family. In arguing for an approach that pays attention to the intra-personal and relational dynamics of neglect, we draw specifically on attachment theory and consider how Ainsworth's (1978) typology of attachment patterns can shed light on parenting styles and patterns of family functioning associated with chronic neglect. We use the concept of the 'internal working model' to develop an understanding of the ways in which family members understand and live out their relationships—with each other and with the worker. We conclude by suggesting that this relational approach requires an ability on the part of the social worker to work both with and within relationships, and look at the contribution that a critically informed relationship-based approach can make to work with families where child neglect occurs.     

Drug prevention with high risk families and young children

The effects of a school and home-based drug prevention program on risk factors for subsequent alcohol, tobacco, and other drug (ATOD) use among children were studied. Data on parent and child risk factors for ATOD use were collected from fifty-six low-income parents and their children, ages four to six years, using a pretest-posttest design. The parent-child intervention was conducted over a two-month period. The intervention had no effect on parent or child risk factors. However, the program was favorably received by parents and children. Almost two-thirds of the parents at the experimental school were involved in the program. Almost half of the parents had high depressive symptoms. The high rates of ATOD use and depressive symptoms among these parents are cause for concern.     

Information and communication technologies in interventions of Czech social workers when dealing with vulnerable children and their families

ABSTRACT

The topic of informatization and digitization of social work is a new phenomenon bringing new challenges that need to be dealt with. However, in the Czech Republic, the processes of informatization, digitization and e-social work may still look like grey zones. This article presents the result of one of the first Czech studies whose aim was to find out how social workers interpret the impacts of the use of information and communication technologies on social work. The goal of the research was to find out how the ongoing process of informatization permeates the Czech social work aimed at the target group of vulnerable children and their families. The authors have applied a qualitative research strategy in this research project using semi-structured interviews as the technique of data collection. The utilization of this technique has enabled them to obtain information from 25 social workers. The interviews have been analysed using the procedures of situational analysis. When interpreting the results, the authors focused on the area of communication where information and communication technologies are used, which social workers considered crucial.     

Therapeutic interventions with families with psychotic young children

Mahler's theory of infantile psychosis focuses on the distortion or omission of the symbiotic relationship between mother and child. The child's defective utilization of the mother, often a result of constitutional vulnerability, prevents internalization of the mother's functions, ego development, and differentiation of self. The child's deficiency may also exacerbate the mother's vulnerabilities, causing her to respond in ways which further inhibit the child's development. This article presents the treatment of two families, each with a child suffering from infantile psychosis.     

Working with autistic children and young people: sense, experience and the challenges for services, policies and practices

This paper aims to create narratives of autistic experience that are not restricted by a primary consideration of impairments or deficits but rather related to ideas about 'assets' as a means of developing professional practice. It is argued that children's rights legislation (UN Convention on Children's Rights, 1989, and in the UK, the Special Educational Needs and Disability Act, 2001) can encourage professionals working with autistic young people to search imaginatively for ways of conceptualising and accessing not only those assets but also the thoughts and feelings of their clients. Examples are taken from the author's own casework as well as from autistic 'insider' accounts which, it is argued, are providing insights into the inherently social contexts for the development of human feelings, thinking and meaning. While primarily directed at professionals, the intention is to encourage theories and the development of practices which are responsive to the wishes and views of disabled people and as such assist in their 'fight for full equality and social inclusion'.     

Early intervention services for very young children and their families under P.L. 99-457

This article addresses early intervention services for children, birth to kindergarten age, who experience developmental deficits and delays that may later be identified as learning disabilities. P.L. 99-457 is briefly reviewed with a focus on elements that emphasize family-centered practice. Vignettes are presented to illustrate interventive strategies that promote parent empowerment, and parent-professional and interagency collaboration.     

Problems confronting migrants and members of their families when they return to their country of origin

The problems which migrants and their families face when they return to their own country arise from the personal circumstances of the individuals themselves as well as the characteristics of both the country of origin and the host country. A great variety of conflicts can arise during reintegration and the interrelation between them is complex. Nevertheless, some problems occur more frequently than others; a number of the most common include the following: 1) reintegrating the return migrant into the labor force is very difficult, particularly when unemployment is a problem in his homeland. 2) Degrees earned abroad often do not transfer from one high school or university to another at the same academic level. 3) Most returning migrant workers lose their retirement benefits acquired during the period of emigration because of no social security convention between the countries concerned. 4) Patriotic feelings and ties to family and friends lead the migrant to gloss over the real problems he faces. 5) Migrant children commonly face problems related to education because of differences between languages, teaching contents, and educational methods practiced in the two countries. Recommendations to relieve these and other problems migrants face upon reintegration include: 1) efforts should be made to orient return migration when jobs are available; 2) cultural agreements allowing recognition of studies and accreditation of degrees and diplomas should be promoted; 3) social security conventions between countries should be extended to include the transfer of benefits and recognition of years of work; 4) priority should be given to educational problems faced by migrant children with a dual sociocultural identity; and 5) assistance should be given to countries in carrying out empirical studies on reintegration problems and measures to solve them.     

Reframing risk for transgender and gender-expansive young people experiencing homelessness

This article expands conceptualizations of homelessness among transgender and gender-expansive young people beyond those associated solely with risk and victimization. Participants were 27 New York City–based transgender and gender-expansive young people (between the ages of 18 and 25) with histories of homelessness. This exploratory inquiry utilized semi-structured interviews lasting approximately 60 minutes. Participants shared another side of their homeless experiences that challenge the risk paradigm, describing their homes as primary sites of risk, from which they were fortunate to escape. Once homeless, they described finding a community of which they felt a part, accessing information they needed, and developing skills of which they were proud. The findings from this study have the potential to guide practice, policy, and research and to inform prevention and intervention strategies for transgender and gender-expansive young people experiencing homelessness.     

Unmet service needs of families of young children with chronic illnesses and disabilities

Data about health and educational services were collected from 187 families with young children (under two years) who have chronic illnesses and disabilities. The purpose was to assess parents' satisfaction with services their families received and to identify families' unmet service needs as well as the reasons for these unmet needs. Although families' ratings of the adequacy of services are relatively high, 28% of the families report unmet service needs. The unmet needs most often reported are occupational, physical, or speech therapy; respite care/child care; and special education. Lack of funding is the most commonly given reason for unmet needs. Children with multiple impairments are at highest risk for unmet needs. Only 22% of unmet needs reported at the initial interview have been met by the time of the six-month follow-up. Increased coordination and monitoring of services across service sectors are indicated. Her research interests include the effects of disability on family identity and families' responses to minority stress. She received her Ph.D. from the University of Minnesota. She gratefully acknowledges Shelley Blazis and Nadav Casuto for statistical consulting. Her research interests focus on the impact of chronic illness and disability on families. She received her Ph.D. from the University of Minnesota. Her research interests include families and health and chronic illness and disability in children. She received her Ph.D. in Family Social Science at the University of Minnesota. His areas of interest include neurodevelopmental outcomes of low birth weight infants and training in developmental pediatrics. He was graduated from the University of Minnesota Medical School. His areas of interest include adolescents with chronic illness and disabilities, adolescent sexual decision making, and international adolescent health care issues. He was graduated from Howard University College of Medicine was awarded his earned doctorate in Health Policy from the University of Minnesota. Preparation of this article was supported by the National Institute on Disability and Rehabilitation Research Grant #H133890012.     

Effective child welfare practice with immigrant and refugee children and their families

This article presents a multistage migration framework to broaden the lens through which child welfare personnel can view immigrant and refugee families and their children. By better understanding the family's experiences in both emigration and immigration, including reasons for leaving their home country, experiences in transit, and reception and resettlement experiences in the United States, child welfare personnel are better equipped to assess their needs and provide effective prevention, protection, permanency, and family preservation services. Case examples illustrating the application of the framework and guidelines for program and practice are included.     

Parental involvement and young women's contraceptive use

Young adult women in the United States tend to delay family formation, pursue higher education and professional jobs, and become sexually active before marriage. Using effective contraception is the best way to ensure that nonmarital parenthood does not disrupt educational and career plans. Because parental involvement in education shapes teenagers’ attitudes about school and work by encouraging achievement and by providing a home environment that values education, this study assesses whether it may also influence contraceptive choices during early adulthood. Analysis of data from 3,828 young women who participated in the National Education Longitudinal Study indicates that parental involvement not only increases the odds that young adult women use contraception, but it is also tied to the likelihood of using specific birth control methods.