Children In Military Families Research Articles

Children’s Social, Emotional, and Behavioral Outcomes in Military Families: A Rapid Review

AbstractIn light of ongoing global military conflicts, including the Israel-Hamas war and the Russia-Ukraine war, it is imperative to study the effects of parental military service and deployment on the health and well-being of children within military families. Emerging evidence suggests that children with a parent in service appear to face unique developmental challenges associated with the military lifestyle, which differ from those experienced by civilian children. However, there is currently limited systematic research that compares the developmental outcomes of children with serving parents to their civilian peers. Therefore, the aim of this review is to synthesize existing literature on the behavioral, social, emotional, and educational functioning of children with currently serving parents in defense forces, in comparison to their civilian counterparts. This rapid systematic review was conducted in accordance with the Joanna Briggs Institute methodology framework, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and Cochrane Rapid Review methodological recommendations The following databases were searched: Medline, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials. Relevant online databases were searched from February 2012 to 2022 to examine the contemporary literature. Fourteen identified published quantitative studies were identified. No qualitative studies were found, and no study reported on academic outcomes. Despite considerable sample heterogeneity across studies, military children of all ages appear to be a particularly vulnerable population. Findings suggest that children in military families experience substantially higher risk for negative psychological, social, and behavioral health outcomes than their civilian counterparts, with parental deployment increasing risk across all developmental stages (i.e., early, middle, and late childhood). Among these age groups, adolescents of currently serving members showed highest risk, particularly concerning suicidal ideation and suicidal behaviors. Implications are discussed in terms of early detection, preventative interventions, and support services for families and children with a serving parent. PROSPERO registration: CRD42022313999.

Adverse Childhood Experiences andPositive Childhood Experiences Among United States Military Children.

Many facets of military life are contributors to child health including frequent mobility, family separation, and increased risk to parental physical and mental health, as well as strong social networks and military support systems; yet, there has not been an examination of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) among military children. This study used the 2020-2021 National Survey of Children's Health, limited to children aged 6 to 17 years of age, to examine the association between a child who has ever had a caregiver on active duty and their exposure to ACEs and PCEs (n = 54,256 children). Bivariate analyses used Pearson's chi-squared tests and were weighted to be nationally representative. Multivariable regression models were used to examine the association between military status and selected ACEs. There were no statistically significant differences in PCEs between military and civilian children. Compared to children with a civilian caregiver, children who had a caregiver who had ever served on active duty had a higher odds of experiencing domestic violence (adjusted Odds Ratio (aOR), 1.61; 95% CI 1.23-2.11), mental health issues or depression in the household (aOR 1.28; 95% CI 1.07-1.52), and substance use (aOR 1.28; 95% CI 1.06-1.55). This study complements and extends previous research that has taken a deficit approach and focused exclusively on the hardships faced by children in military families. The findings from this study may be instructive for child welfare advocates and policymakers as they intervene in communities with programming that promotes PCEs among children and adolescents.

Associations of Warzone Veteran and Intimate Partner PTSD Symptoms with Child Depression, Anxiety, Hyperactivity, and Conduct Problems

Warzone deployment increases risk for posttraumatic stress disorder symptoms (PTSS), including among service members who have children. Parental PTSS are associated with child depression, anxiety, hyperactivity, and conduct problems, yet few studies of child behavioral health outcomes in military populations have accounted for PTSS in both warzone veterans and their partners. Fewer still incorporate non-clinically-recruited samples of nationally dispersed warzone veterans and their families. The current research examines whether children whose parent(s) have higher levels of PTSS exhibit more behavioral health symptoms. One hundred and thirty-three Iraq and Afghanistan War veterans and their cohabitating partners completed clinical interviews and self-report questionnaires. Higher intimate partner PTSS, more extensive child exposure to stressful life events, and being an adolescent were significantly associated with child depression after adjusting for warzone veteran PTSS, demographics, and recent warzone veteran absence from the household. Greater child exposure to stressful life events was also associated with child conduct problems. Treatment of PTSD symptoms experienced by warzone veterans’ intimate partners, and preventative interventions aimed at helping the children of warzone veterans cope with stress, may ultimately yield positive benefits for the behavioral health of children in military families.

Adverse Childhood Experiences in Military, Veteran, and Civilian Families

Adverse childhood experiences are traumatic early life experiences that can lead to poorer mental, physical, and social outcomes. Children in military and veteran families can face unique challenges compared with civilian families. This study utilizes data from 2017–2019 National Survey of Children’s Health to examine 56,655 children living in military, veteran, and civilian families to predict the prevalence of adverse childhood experiences. Findings indicate that children living in veteran families (compared with civilian families) have higher odds of witnessing parents use violence and witnessing parents with alcohol or substance use problems. Children in military families had higher odds of divorce and lower odds of experiencing parental death. It is also noted that children living in military, veteran, and civilian families are similar across other ACEs including the incarceration of a parent, child as victim of violence, living with family with mental illness, unfair treatment because of race, and difficulty covering basics like food and housing.

Epidemiology of obesity and high blood pressure among school-age children from military families: the largest report from our region

BackgroundFor the first time, we aimed to determine the epidemiology and associated factors of obesity and hypertension among children of military families in our region.MethodsIn this multi-centered study, children between the ages of 5 to 12 years old, entered the study. Data on baseline and clinical characteristics, history of disease and anthropometric measurements, were collected.ResultsAmong 504 children, 44.2% were males. Mean (SD) age of participants was 7.9 ± 1.9 years. Overall, 5% were obese and 9.9% were overweight. In total, 16.3% had elevated BP, 12.5% had stage one and 0.2% had stage two hypertension.Age (beta = 0.306, OR = 1.35, 95% CI:1.14—1.61), obesity/overweight (OR = 5.58, 95% CI:2.59—12.0), history of hypertension in mother (OR = 43.24, 95% CI:5.99—312.11), low birth weight (OR = 7.96, 95% CI:2.59—12.0), physical activity (OR = 0.27, 95% CI:0.10—0.72), and consumption of fast food more than once a week (OR = 3.36, 95% CI:1.82—6.19), were associated with risk of hypertension.Furthermore, age (beta = 0.346, OR = 1.41, 95% CI:1.21—1.64), history of childhood obesity in the father (OR = 3.78, 95% CI: 1.77—8.06) and mother (OR = 2.44, 95% CI:1.07—5.56), and physical activity (OR = 0.27, 95% CI:0.11—0.66), were associated with obesity.ConclusionAge, obesity/overweight, history of hypertension in the mother, birth weight, physical activity, and consumption of fast food, were associated with risk of hypertension. Moreover, age, history of childhood obesity in parents, and physical activity, were associated with obesity.Furthermore, we found that school-age children in military families have higher rates of hypertension and overweight compared to other reports from our region.

Mental Health of Canadian Children Growing Up in Military Families: The Child Perspective

A recent scoping review indicated military-connected children face stressors that may increase mental health issues. However, the majority of the included literature was American. To examine the experiences of Canadian military-connected children, we conducted in-depth interviews with a purposive sample of Canadian military-connected youth using a qualitative description approach. We conducted a content analysis on interview data, supported by qualitative data analysis software (MAXQDA), with coding done by two researchers who met regularly to discuss coding agreement. Thirteen children in military families participated and described the mental health impact of frequent mobility, parental absence, and risk of parental injury. The experiences of our participants were consistent with the results of an earlier scoping review on this topic. Our results suggest improving military cultural competence among health care providers and enhancing parental support may positively impact child well-being. More research is needed to understand resilience and vulnerability among Canadian military-connected children.

Military Children: Unique Risks for Mental Health and Wellbeing and Implications for School-Based Social Work Support

ABSTRACT Children in military families experience a unique combination of stressors associated with military life that may affect every stage of their lives, including their mental health, as well as disrupt their schooling and consequent social, emotional, and academic development. A review of the key issues faced by children is presented including the challenges in providing school-based social work support. A case vignette is used to illustrate how an ecological framework can address many of the unique aspects of military life that affect children, such as mobility, multiple deployments, recent relocation, mental health and wellbeing, family stress, and their impact on social, emotional, and academic outcomes.

Evaluating the KidCOPE for Children in Active Duty Military Families.

The KidCOPE is a widely used measure designed to examine how children cope in the face of stressful events. The current study aimed to replicate the factor structure of the KidCOPE found in four prior studies. KidCOPE responses from children of military families (2256 children, ages 7-12years, 47.9% female, Age M = 8.90, SD = 1.62) enrolled in the Families OverComing Under Stress (FOCUS) at baseline were used. No prior factor structure could be replicated. The sample was then split, and exploratory and confirmatory factor analyses were conducted. A 2-factor model including factors for generally positive and negative coping was identified; but not confirmed. Overall, this study supports prior research suggesting limitations of the KidCOPE as a valid measure of coping style.

Assisting military families

Last month, Remembrance Day provided an opportunity to pay tribute to the armed forces. Health visitors have a crucial role in identifying children of military families, and helping to improve health outcomes, particularly health and emotional wellbeing

Military-Connected Children: Applying the Competencies for Counseling Military Populations

ABSTRACT Children in military families may face risk factors in the course of their caregiver’s service, including separation, attachment, grief, loss, and mobility, which may result in emotional or behavioral difficulties. Counselors are more effective when prepared to address the unique needs of military-connected youth in culturally responsive practices. In this article, the authors review literature which describes the mental health needs of children in military families, provide a case application example, and present a model for applying the Competencies for Counseling Military Populations.

Programs for children in military families

Introduction: This article reviews representative programs for families and children from each NATO and Partnership for Peace (PfP) country with a representative participating in the NATO HFM RTG-258 task group on the impact of military life on children in military families. Methods: Each participating country was invited to submit up to three programs targeted at military-connected children and families. Results: 26 programs from nine countries were reviewed and categorized into 13 typologies. Discussion: The number of services offered in each country appeared to be influenced by size of the military, the degree to which military life is separate or immersed in civilian life, and the access to universal and preventive health care. Program descriptions for representative programs are included, as well as recommendations for program development, evaluation, and implementation.

Children in military families: establishing international collaboration

Children in military families: establishing international collaboration

Children from military families: looking through a transnational lens

Introduction: The purpose of the NATO Human Factors Medicine Research Task Group-258 (HFM RTG-258) was to develop a theoretical model of well-being for children from military families so as to assist militaries and service providers in identifying the most effective supports for military families and their children. Methods and Results: Building on existing models of children’s well-being and the socio-political context of NATO and Partnership for Peace (PfP) nations, as well as the unique challenges of military life, we developed the health, education, legal, material, and social (HELMS) model, a universal framework for the well-being of children in military families. The model is specific to the unique aspects shared by military families and children while allowing for the differences and similarities of military families across different nations. Our aim is also to initiate a dialogue beyond NATO and PfP nations, and our task group serves as a forum for active collaboration on surveys and metrics to guide current and future work. Discussion: The outcome of this NATO task group will not only benefit NATO military families and its partner nations, policy makers, and military organizations internationally, but it will also help service providers identify the most effective ways of providing support to military families and their children.

Development of a model of well-being for children from military families in NATO countries

Introduction: This article describes the development of a model of well-being for children from military families in NATO countries. Methods: The development comprised seven phases: (1) a review of the participating NATO countries’ literature (current theory and research); (2) an outline of the key elements of a model of child well-being; (3) the identification of potential indicators of child well-being; (4) the identification of the components and dimensions of child well-being; (5) a review and refinement of the model; (6) the inclusion of the military factors that influence child well-being; and (7) the development of a definition for child well-being. Results: Thematic analysis was used to identify the well-being indicators, dimensions, and components. The process was informed by the subject matter expertise of the NATO Human Factors Medicine Research Task Group-258 (NATO HFM RTG-258), the civilian literature, and military factors associated with child well-being. Discussion: Central to the developed child well-being model are five dimensions of child well-being: health, education, legal, material, and social (HELMS). This model is closely aligned with well-established models and measures of well-being – Bronfenbrenner’s bioecological model of human development, Minkkinen’s structural model of child well-being, and the Organisation for Economic Co-operation and Development’s (OECD) measures of child-well-being. The proposed model takes into consideration relevant military factors that influence the well-being of children in military families.

School Utilization of Spouse Perspectives on Military Parental Absence for Program Planning

Abstract The negative effects of military work-related parental absences on military families and military children in particular have been detailed in the literature. Family adjustment to increased stress during deployment is influenced by the family’s perceptions of the stressors. In the study reported in this article, military spouses (N = 79) were interviewed so researchers could gain an understanding of the spouses’ perceptions of the effects (for example, concerns, unmet needs) of military work-related parental absences on the overall family system and could identify contextual risk and protective factors that contribute to the well-being of children in military families. Results are presented as percentages of spouses’ theme responses and exemplary quotes. Unmet needs included individual child counseling, parental-absence support programs, age-specific programming for children, child care needs, availability of parenting programs, lack of awareness of programs for students and parents, and supports for exceptional family members. Recommendations for schools to meet these unmet needs are provided following a tiered support framework to better support military families during parental absences.

Children of Military Families

There are special considerations when treating depression in the children of military families, due to both unique stressors and unique access to treatment and support resources. This article provides a brief overview of the history of military family care, an understanding of ongoing efforts to provide excellent and timely care for these children, and an understanding of the unique stressors and challenges that the depressed military child faces. The Department of Defense is dedicated to providing for the unique needs of military children and providing robust services to care for these children and their families.

A systemic perspective on children’s well-being in military families in different countries

Introduction: Children are influenced by different environments – home, friends, school, community, society, and the existence and availability of various services – and child well-being is the outcome of the interrelationships between the child and these environments. The military is one of the environments that shapes the well-being of children in military families, and the environments interact with each other. Methods: Our main assumption is that the effect of military environment on child well-being may vary in different societies depending on the general social security system. We describe how the military children’s well-being is embedded in military systems, which in turn is embedded in welfare state. The main question is how the well-being of children from military families varies across countries and how much variation can be explained by the interplay between military systems and different welfare regimes. Results: We begin by describing the differences in welfare states and military systems, and then give a short overview of children’s well-being in the context of different welfare regimes (e.g., availability of public child care, health care, and access to education and extracurricular activities). Discussion: Next, we look at the interplay between the military and welfare regimes and, finally, we show how the well-being of military children is supported across countries by their different welfare regimes.

Prevalence of childhood asthma in US military and non-military families: Comparisons by rural-urban residence and geographic region.

We sought to determine variables associated with asthma among children from military and non-military families. We performed secondary data analysis on the 2016 Behavioral Risk Factor Surveillance System. Parents with and without military experience (n = 61,079) were asked whether a child ever had asthma and currently has asthma. We used two multiple logistic regression models to determine the influence of rurality and geographic region on "ever" and "current" asthma in children of military and non-military families, while controlling for socio-demographic and behavioral variables. Overall childhood asthma prevalence for children in military families was lower than non-military families (ever, 9.7% vs. 12.9%; currently, 6.2% vs. 8.2%) in 2016. However, multiple logistic regression showed variation in "ever" and "current" asthma among children of military and non-military families by rurality and race. Developers of public health asthma interventions should consider targeting African-American children of military families living in urban areas. This population is approximately twice as likely to have asthma as Caucasian children of non-military families.

The intergenerational consequences of war: anxiety, depression, suicidality, and mental health among the children of war veterans.

The long-term effects of military deployment on the mental health of war veterans have been investigated extensively, but few studies have examined the long-term impact of parental deployment on children's mental health. Using a retrospective, multigenerational survey and propensity score analysis to adjust for selection effects and endogeneity bias, we investigated the impact of parental deployment on the mental health of the adult children of Australian veterans of the Vietnam War. We analysed data from 1966 adult men (35%) and women (65%) whose fathers (N = 1418) were selected at random from the population of surviving men who served in the Australian army during the Vietnam War (1962-75). Mean age of respondents was 37. The main outcome measures were self-reported diagnosis or treatment for anxiety and depression (i.e. lifetime and previous 12 months), suicidality based on Psychiatric Symptom Frequency Scale, and current mental health as measured by the Mental Health Inventory of the SF-36. The key independent variable was whether their fathers were deployed to the Vietnam War. Almost 40 years after the war, the adult children of deployed veterans were more likely to have been diagnosed with anxiety [odds ratio (OR) = 1.54, confidence interval (CI) = 1.04, 2.28] and depression (OR = 1.77, CI = 1.03, 3.05), to have had thoughts of suicide and self-harm (OR = 2.39, CI = 1.57, 3.65) and to have made suicidal plans (OR = 3.52, CI = 1.40, 8.85) than the offspring of comparable, non-deployed army veterans. They also reported poorer current mental health (Coefficient = -5.08, CI = -6.60 - -3.56). The results imply that there are significant and enduring adverse effects of parental deployment on the mental health of children in military families, and provide some insight into the potential long-term impacts of recent military engagements in Afghanistan and Iraq.

School participation and children in military families: A scoping review

ABSTRACTChildren from military families experience high mobility, stressors due to parental separation and increased risk of parental injury and death. This study aimed to identify and describe school-related occupational disruption for students from military families. Arskey and O’Malley’s structured approach to scoping reviews was used. Students in military families experience occupational challenges in managing transitions across schools, maintaining academics, developing social relationships, and engaging in extracurricular activities. The environment can also enable school-related occupations. Occupational therapists are encouraged to consider military-connected students as a vulnerable population and use school-based services to address mental health issues.