Professionals' and parents' perceptions of A&E use in a children's hospital

Helpful keywords in accessing literature on the use made of hospital accident and emergency (A&E) departments are ‘misuse’ ‘abuse’ and ‘inappropriate’. While the medical literature is inclined to present patients (and, in the case of children, their parents) as irresponsible, or misguided, social scientists looking at similar data have tended to act as apologists for patients, explaining A&E attendance in terms of poor access to GPs, mistaken beliefs about the relative skills of hospital-based doctors and GPs and ‘lay’ health beliefs. Both of these approaches see the patient (or parent) as passive recipients of health care, rather than active caretakers of their own or their children's health. On the basis of a study of minor ailments presenting at a children's A&E department, this paper explores the differing views of health workers and parents. It suggests that a view of patients (parents) as largely passive custodians of their own or their children's health is inadequate. Patients (parents) can and do play an active part as providers of primary health care and their decisions to use A&E are not as irrational as health providers sometimes suppose. In this light, attempts to ‘re-educate’ parents to use A&E in a way which would be more acceptable to health providers is unlikely to succeed.     

Why more ‘quality time’ is not on the top of children's lists: the ‘qualities of time’ for children1

For many years the everyday reality of working parents and their children has been captured in notions of ‘quality time’ versus ‘quantity time’. On the one hand it is suggested that what families need is ‘more time’ for parents to spend together with their children and less time working. On the other hand this has been countered with arguments saying that attention has to be paid to how parents spend their time together with their children. As a result quality time is often presented through idealised images of ‘happy families’. Quality time is seen as parents engaging with their children in particular activities or outdoor excursions that create and maintain family enjoyment, care and togetherness. However, such debates are based on assumptions of what would be ‘good’ for today's children and neglect the perspective of children themselves. This paper draws on field research carried out with 10–11‐year‐old children on their understandings and use of time in an urban and a rural setting in the north of England. The paper points to five ‘qualities of time’ identified by children. These qualities suggest that children's views of time spent with their families cannot be seen as separate from the time they spend with friends, at school and on their own. The paper argues that the quality/quantity time conundrum needs replacing by fuller and more representative accounts of the varied aspects of time that matter for children. These need to be situated in the processes through which family, school and work life take place on a daily basis and in relation to children's life course. Copyright © 2002 John Wiley & Sons, Ltd.     

I agreed to go because........examining the Agency of Children within a phenomenon conceptualised as trafficking in Ghana

The legal and policy framework on child trafficking is dismissive of children's agency and regards them as vulnerable personalities. This paper examines the scope of children's agency in their transportation to other communities for fishing in Ghana. Using a phenomenological design, 17 child returnees' views were elicited on their movement for fishing activities. Findings revealed that children's agentive capabilities progressed primarily from consent giving to negotiation. Highlighting the relational and material context within which children's agency unfolds, the study suggests that it is erroneous to generally ascribe the discursive label of ‘innocence’ to children who are considered as trafficked.     

Re‐framing the Analysis: A 3‐dimensional Perspective of Prisoners’ Children's Well‐being

This article highlights three dimensions to understanding children's well‐being during and after parental imprisonment which have not been fully explored in current research. A consideration of ‘time’ reveals the importance of children's past experiences and their anticipated futures. A focus on ‘space’ highlights the impact of new or altered environmental dynamics. A study of ‘agency’ illuminates how children cope within structural, material and social confines which intensify vulnerability and dependency. This integrated perspective reveals important differences in individual children's experiences and commonalities in broader systemic and social constraints on prisoners’ children. The paper analyses data from a prospective longitudinal study of 35 prisoners’ children during and after their (step) father's imprisonment to illustrate the arguments.     

Young people's views of children's rights and advocacy services: a case for ‘caring’ advocacy?

This paper looks at some preliminary findings from research with young people in foster and residential care in the UK who have received advocacy services from a range of local authority and voluntary agencies. The study also includes the views of professionals, from both children's rights and social services. The initial findings highlight the importance to young people of their relationship with rights professionals. They speak about the value to them of care and respect, aspects not always seen as fundamental to rights work. Caring, in its various guises is seen by young people as a vital component of their relationship with children's rights workers. They also see this as important within advocacy work itself since caring about the outcome is often key. A pure individual rights focus with an emphasis on challenge and ‘being heard’ may not take account of the complexity of their situation and may pose difficult dilemmas for young people, especially in dealings with their carers. This ‘caring’ advocacy is not the paternalistic approach of a professional who ‘knows what's best for you’ but is a model based on a strong awareness of ways that young people are excluded and oppressed. It is also about placing a positive value on their contribution as citizens and links to a view of society that gives importance to an ethic of inter‐relationship and care as well as an ethic of individual rights. Copyright © 2007 John Wiley & Sons, Ltd.     

What's in a name? An exploration of the significance of personal naming of ‘mixed’ children for parents from different racial,ethnic and faith backgrounds

This article is concerned with how and why parent couples from different racial, ethnic and faith backgrounds choose their children's personal names? The limited literature on the topic of names often focuses on outcomes, using birth name registration data sets, rather than process. In particular, we consider the extent to which the personal names that ‘mixed’ couples give their children represent an individualised taste, or reflect a form of collective affiliation to family, race, ethnicity or faith. We place this discussion in the context of debates about the racial and faith affiliation of ‘mixed’ people, positing various forms of ‘pro’ or ‘post’ collective identity. We draw on in‐depth interview data to show that, in the case of ‘mixed’ couple parents, while most wanted names for their children that they liked, they also wanted names that symbolised their children's heritages. This could involve parents in complicated practices concerning who was involved in naming the children and what those names were. We conclude that, for a full understanding of naming practices and the extent to which these are individualised or affiliative it is important to address process, and that the processes we have identified for ‘mixed’ parents reveal the persistence of collective identity associated with race, ethnicity and faith alongside elements of individualised taste and transcendence, as well as some gendered features.     

DEPENDENCE AND INDEPENDENCE

The contributions that adult men and women make to households in terms of paid and unpaid work have undergone substantial change, particularly in respect of women's responsibility for income generation, and have been seen as part of the processes of individualization. Recent contributions to the literature have suggested that children are now acquiring independence earlier as part of those same processes. The paper uses qualitative methods to explore the way in which parents in two-parent families, where both are employed, perceive the risks attached to children's exercise of greater independence, how they seek to ‘manage’ those risks and how far the perceptions of parents accord with those of children. We find parents’ perceptions of risk to be strong, but to have little to do with working patterns. In addition, they are often at odds with the actual behaviour of the child. Risks are managed by negotiation, in which children played an active part. We are also able to make some preliminary comments on the difficulties of interpreting scale measures in relation to interview evidence.     

From parity to subsidiarity? children's policy in Northern Ireland under New Labour: the case of child welfare

The central challenge in evaluating any aspect of children's policy in Northern Ireland is finding a way to combine acknowledgement of the political violence and instability that marks it out from other UK jurisdictions with recognising its experience as a variation on shared themes. In this paper the devolution agenda of New Labour is related to the progress being made in the peace process and its implications for children's policy considered through focusing on child welfare. With illustrations from policy, legislation and practice, the traditional social policy commitment to ‘parity’ is shown to have always involved negotiation and accommodation between the realities of the region and Westminster's objectives. It is suggested that under New Labour that is continuing and that the term ‘subsidiarity’ may prove helpful in describing and engaging in this process. Copyright © 2003 John Wiley & Sons, Ltd.     

The ‘Go‐Between’: Low‐Income Children Negotiating Relationships of Money and Care with Their Separated Parents

The UK is moving from a centralised administrative child support system to one of private ordering where the state will only intervene under limited circumstances. This requires parents to agree and set up suitable, sustainable arrangements. This has particular implications for children, although the child perspective is often overlooked. This article situates children as active social agents exploring their interactions and negotiations with their separated‐parents with regard to money, time and parenting. It argues that policies that do not take into account the agentic child's experiences and perspectives may fail to address the impact of policy on children's lives.     

Attitudes of special foster parents and residential staff towards children

This paper compares the attitudes of special foster parents and residential staff towards children in their care. The exercise was carried out as part of a comparative study of care practice in ‘special’ foster homes (accommodating children traditionally considered too old or difficult for fostering) and ordinary community or children's homes. Overall, care practice in the foster homes was significantly more child oriented than in the children's homes. This finding cannot, however, be explained in terms of attitudinal differences between foster parents and staff. Staff attitudes generally appeared more conducive to the provision of child oriented care than those of the foster parents.     

Of Roots and Wings: Letting Go of the College‐Bound Child

This article examines how parents experience the process of “letting go” of their college‐bound children. The focus of our analysis is on how the parents evaluate the meanings of their children's leaving home and adopt strategies to facilitate the process for both themselves and the departing child. Our analysis is based on interviews with thirty sets of parents. The interview materials allowed us to recognize and then parse the paradoxical task faced by parents of fostering “attached individuation” for both themselves and their children. We address four broad and persistent themes that emerged from our conversations with parents. First, we consider how parents manage the range of sometimes‐conflicting emotions generated by the letting go process. Second, we analyze the content of parents' worries as a good unobtrusive measure of how they understand the transition to college as a ritual marker in their children's lives. Third, we show how negotiations about geography—about proper distance from home—in choosing a college reflect efforts to impose a measure of gradualism into the letting go process. Fourth, we report on how parents theorize the impact of a child's departure on family relationships in general.     

Whither practice-near research in the modernization programme? Policy blunders in children's services

In this article, we lament the effects of practice-distant research and associated policy initiatives on contemporary children's services in England. In the last decade, as a result of high profile inquiries into non-accidental child deaths, statutory children's social care services in the UK have been subject to a wide-reaching ‘modernization’ programme. We studied decision-making in the high blame environment of local authority children's services. Our research sought to examine the relationship between performance management and the impact of anticipated blame within the decision-making practices of those providing, supervising and managing these services. We show that systems and technologies can be developed which both assist the users in their daily work and achieve desired organizational goals, but without an ethnographically informed, practice-near approach, unsafe work regimes and practices can ensue.     

Paradoxical Pathways: An Ethnographic Extension of Kohn's Findings on Class and Childrearing

Stratification is a central issue in family research, yet relatively few studies highlight its impact on family processes. Drawing on in‐depth interviews (N = 137) and observational data (N = 12), we extend Melvin Kohn's research on childrearing values by examining how parental commitments to self‐direction and conformity are enacted in daily life. Consistent with Kohn's findings, middle‐class parents emphasized children's self‐direction, and working‐class and poor parents emphasized children's conformity to external authority. Attempts to realize these values appeared paradoxical, however. Middle‐class parents routinely exercised subtle forms of control while attempting to instill self‐direction in their children. Conversely, working‐class and poor parents tended to grant children considerable autonomy in certain domains of daily life, thereby limiting their emphasis on conformity.     

Children's agency and its contradictions in the context of transnational labour migration from Vietnam

In this article, we contribute to the growing and diverse literature on the lived experiences of children and their agency in the context of migration. Drawing on in‐depth interviews with children whose migrant parents have left them behind, as well as with those who care for them in Vietnam, we demonstrate that the various ways in which they affect migration decision‐making and transnational communication shape the children's imaginations of migration. The context‐specific social construction of childhood, or more specifically adult perceptions of children's agency and needs, in turn structures these processes. We emphasize the need for debates on children's agency to take into account both broader socio‐economic processes at the macro level and the concrete and local scale at which children's lives unfold. By outlining how children's experiences of parental migration are constitutive of their attitudes toward this livelihood strategy, we also argue that the ability of those ‘left‐behind’ to exercise agency is closely intertwined with processes of social becoming and navigation in the transnational social fields constructed for them by adults.     

The Development and Initial Validation of the COPLAG Scale: Measuring the Concerns of Parents of Lesbians and Gays

This article discusses the development and initial validation of a scale designed to assess parents’ concerns upon their learning about their children's gay or lesbian sexual orientations. Principal Component Analysis (PCA) of the scale's items resulted in a three-factor solution distinguishing among parental concerns about (1) their children's physical, psychological, and social well-being, (2) themselves as parents of gay or lesbian children, and (3) being rejected by loved ones.     

Time for work,commuting, and parenting? Commuting parents' involvement with their children

For most Australian parents, there is continuing tension between work and family commitments. This tension is exacerbated by the need not only to have sufficient time available to children in the family but also for that time to be characterized by nurturance and guidance. This article reports on a qualitative study that explored how 21 part-time or full-time working parents, who also commute 10–15 hours a week to work, manage both the quantity and quality of their time with their young children (0–5 years). The study revealed the difficult conditions of commuting and the importance of social support to parents' well-being, as well as a significant pattern of parent–child interaction which we have described as ‘attentive parenting.’ Parents felt these activities contributed to the parent–child bond and their children's well-being in spite of an acknowledged lack of interactive time.     

Quality in services for disabled children and their families: what can theory,policy and research on children's and parents' views tell us?

Many discourses surround the concept of ‘service quality’, however, it continues to remain partial and ambiguous. This paper seeks to unpack ‘quality’ in services for disabled children and their families. Theoretical models are initially reviewed and then considered in relation to key policy guidelines, empirical data drawing upon parents' and children's experiences of ‘quality’ in services are presented. This paper demonstrates the many different levels within the concept of ‘quality’ and highlights the importance of recognising and respecting that children and parents frequently value different aspects of ‘quality’. Copyright © 2001 John Wiley & Sons, Ltd.     

The ‘First Three Years’ Movement and the Infant Brain: A Review of Critiques

This article reviews a particular aspect of the critique of the increasing focus on the brain and neuroscience; what has been termed by some, ‘neuromania’. It engages with the growing literature produced in response to the ‘first three years’ movement: an alliance of child welfare advocates and politicians that draws on the authority of neuroscience to argue that social problems such as inequality, poverty, educational underachievement, violence and mental illness are best addressed through ‘early intervention’ programmes to protect or enhance emotional and cognitive aspects of children's brain development. The movement began in the United States in the early 1990s and has become increasingly vocal and influential since then, achieving international legitimacy in the United States, Canada, New Zealand, Australia, the UK and elsewhere. The movement, and the brain‐based culture of expert‐led parent training that has grown with it, has been criticised for claiming scientific authority whilst taking a cavalier approach to scientific method and evidence; for being overly deterministic about the early years of life; for focusing attention on individual parental failings rather than societal or structural problems, for adding to the expanding anxieties of parents and strengthening the intensification of parenting and, ultimately, for redefining the parent–child relationship in biologised, instrumental and dehumanised terms.