Children In Ontario Research Articles

Psychopathology among children placed in family foster care

The literature on psychopathology among children in family foster care published in the last 20 years was reviewed to estimate prevalence and types of psychopathology in this population. A comprehensive computerized database was searched for the period 1974 through 1994, with emphasis on recent literature. Available evidence suggests that the prevalence of psychopathology among children in family foster care is higher than would be expected from normative data, even when this population is compared with children who have backgrounds of similar deprivation. As for the types of psychopathology in this population, the only apparent trend is the predominance of externalizing disorders, such as disruptive behavior disorders. A combination of social, psychological, and biological factors may render children in family foster care highly vulnerable to psychopathology.

"Nations are built of babies": saving Ontario's mothers and children, 1900-1940

"Nations are built of babies": saving Ontario's mothers and children, 1900-1940

Educating For Temperance: The Woman's Christian Temperance Union and Ontario Children, 1880-1916

Educating For Temperance: The Woman's Christian Temperance Union and Ontario Children, 1880-1916

Fatal bicycle accidents in children: A plea for prevention

We reviewed the coroner's records of all fatal bicycle accidents occurring in children (aged 0 to 15 years) in Ontario (pediatric population, 2,007,230) between January 1, 1985 and December 31, 1989. The injuries sustained were documented and scored with anatomical injury scores (Abbreviated Injury Score 1985 and Injury Severity Score) and categorized as unsurvivable or survivable. The causes and circumstances were documented from police accident reports. Eighty-one deaths resulted from bicycle accidents, an annual mortality rate of 1.44 deaths per 100,000 children per year. In 74 (91%) of these cases the injuries were deemed unsurvivable, 89% of which were head injuries. Seventy-eight (96%) of the deaths resulted from collisions with motor vehicles. No victim was wearing a helmet at the time of injury. In 70% of the deaths, the cyclist was considered to have caused the collision, either because of a violation of a road traffic law or poor road sense. These findings suggest that more emphasis should be placed on primary and secondary injury prevention by such methods as bicycle safety education for children and the promotion of bike helmet use. In addition, in view of the high incidence of unsurvivable head injury, the introduction of legislation requiring the use of protective helmets should be considered.

Determinants of maternal tolerance of vaccine-related risks.

In a time when informed consent requires knowledge of the risks and benefits of medical care and technology to be communicated to the public, perceptions of benefits and risks of these techniques and procedures take on special importance. The purpose of the present study was to examine the determinants of maternal tolerance of vaccine-related side-effects in their children. A questionnaire was sent to 226 mothers of young children in southwestern Ontario seeking their opinion of the benefits and risks of selected medical procedures. It asked them to identify the risk of serious reactions they would tolerate for a new vaccine with benefits similar to that of pertussis vaccine. The response rate to the questionnaire was 92%. This group of young, well-educated mothers had high regard for some of the most common procedures and treatments used in family practice. The less common and more invasive procedures (heart surgery, brain surgery) were viewed as carrying almost as much risk as benefit. Abortion was perceived as involving more risk than benefit. Levels of acceptable risk with respect to a hypothetical new childhood vaccine were determined. A risk level of 1 in 1 million was the most popular level of acceptable risk, chosen by 25% of the respondents. The next most frequently chosen risk level was 1 in 100,000, chosen by 22%. Tolerance of possible vaccine side-effects did not differ with maternal age, education or prior experience with adverse vaccine or drug reactions. A summary net benefit score was derived for four technologies commonly used in family practice (antibiotics, vaccinations, birth control pills and X-rays).(ABSTRACT TRUNCATED AT 250 WORDS)

Oral Health Knowledge and Habits of Senior Elementary School Students

Despite improvements in children's dental health, and significant resource allocation to health education programs, few recent studies have investigated the associations of oral health knowledge, behaviors, and status. This study of 11-year-old children (N = 6,329) in northeastern Ontario used a supervised self-complete questionnaire and a clinical examination to gather baseline data on, and test associations of, caries and periodontal knowledge, self-reported oral health behaviors and source of knowledge, and oral health status. Results show the children had poor knowledge of caries preventive measures such as water fluoridation, dental sealants, and choice of snack foods. Periodontal knowledge was better, but children confused plaque and calculus. Respondents claimed good oral health habits, with 73 percent claiming to brush at least twice daily, 88 percent claiming to use toothpaste, 42 percent claim to floss at least twice weekly, and 84 percent claiming an annual dental visit. Children with the best knowledge claimed dentist and school as the sources. High knowledge was associated with good oral health habits (P less than .001) and low DMFT score (P less than .001). Good habits were not related to DMFT score (P = .1095). Logistic regression showed high knowledge was associated with English cultural status, urban school area, good habits, having a dental sealant, and attending a fluoride-rinse school (P less than .05). Findings suggest a need to reinforce caries preventive teaching, to investigate the effect of cultural status, dental experience, and residence status on oral health knowledge, and to further test the efficacy of different oral health education programs delivered by different sources.

Murdered children: A comparison of racial differences across two jurisdictions

In order to highlight racial differences in patterns of homicide with child victims, a comparison of murdered children under the age of 14 was undertaken for Illinois and Ontario. Comparison of a Canadian jurisdiction with a U.S. jurisdiction allowed analysis of culturally generated factors. The findings indicate that the rate of homicide against Black children in Illinois was much higher than that for whites in Illinois or for Ontario children overall. More interesting, some of the patterns that emerged suggest that white children in Illinois are killed in ways more similar to children in Ontario than to Black children in Illinois.

Blood lead screening in Ontario children: Blood lead and free erythrocyte protoporphyrin levels

A blood lead survey was conducted on samples from 2459 children aged 3–6 years to determine the prevalence of lead poisoning in children of this age in the Province of Ontario. Lead poisoning, defined as a blood lead concentration ⩾ 1.21 μmol l −1 (25 μg dl −1), was found in 26 subjects (1.1% of the samples). The mean blood lead concentration for children from southern Ontario was 0.50 μmol l −1, and for those from northern Ontario it was 0.37 μmol l −1. Stringent quality controls and independent cross-checks of finger-prick capillary blood sampling were employed in the study. The free erythrocyte protoporphyrin levels were also monitored to detect the presence of iron deficiency in the children.

Ontario Child Health Study. Summary of selected results.

Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.

The prevalence of emotional disorder in children.

This report presents data from the Ontario Child Health Study on the prevalence of individual emotional symptoms, the variation of prevalence rates of emotional disorders as a function of demographic factors, and the rates of service utilization for children with these disorders. To survey Ontario children from 4 to 16 years of age, a stratified random sample of 3,294 children was drawn from all household dwellings listed in the 1981 Census. The prevalence rates for emotional disorders in male and female children aged 4 to 11 years were 10.1% and 10.7%, respectively. For adolescents aged 12 to 16 years, the prevalence rate rose to 13.7% for females and fell to 5.0% for males. Children with emotional disorders were frequently found to meet criteria for more than one disorder. Only one in five children with emotional disorders had received mental health or social services in the 6 months prior to the survey.

Ontario Child Health Study: Patterns of Ambulatory Medical Care Utilization and Their Correlates

Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented--one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.

Blood lead and associated risk factors in Ontario children

The purpose of this study was to determine blood lead levels in Ontario children and to identify those risk factors associated with higher blood lead levels. A random sample of 1315 children aged 7 and younger from urban, suburban and rural Ontario was selected. Blood lead concentration was determined in finger prick blood samples by graphite furnace atomic absorption spectrophotometry. Measurements of lead in air, tap water, soil, and gasoline were also established. Traffic pattern were determined in each area. A questionnaire was administered to a random sample of 800 families of the children tested to assess the presence of other risk factors. Urban children had higher geometric mean blood lead levels (12.02, S.D. = 4.4 μg/dl than suburban children (9.95, S.D. = 3.5 μg/dl, and they, in turn, had higher blood lead levels than rural children (8.91, S.D. = 3.9 μg/dl. Each of these differences is statistically significant (p < 0.001). Fifty four (4.3%) of all children were at or above the alert level of 20 μg/dl. The proportion above the alert level did not differ significantly between urban, suburban and rural children. Blood lead levels were slightly higher for males than females and for pre-schoolers aged 3 and 4, compared to school age children aged 5 and 6. The blood lead levels of these children were significantly lower than that of children surveyed near a point source of industrial emissions. Multivariate statistical modelling resulted in a set of characteristics which best explained the differences in children's blood lead levels. Five of the seven factors most closely associated with children's blood lead levels are measures of lead in the physical environment. The major contributor to air lead in the areas tested was lead in gasoline.

Psychiatric disorder and poor school performance among welfare children in Ontario.

Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non-welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed.

Occupational Therapists' Assessment Practices with Handicapped Children in Ontario

A survey was conducted to identify which approaches and methods of assessment are used by Ontario occupational therapists working with handicapped children; how familiar therapists are with specific aspects of some methods used, how satisfied they are with these methods, and what assessment goals therapists consider important. A questionnaire was mailed to 99 sources which included hospitals, rehabilitation centres, school boards, daycare centres, and private practitioners. Sixty-nine (70%) occupational therapists comprised the sample. The prototypical occupational therapist surveyed has an undergraduate university degree, works full-time as a staff therapist in a rehabilitation centre or hospital with neurologically handicapped children, and has worked for more than five years in the field of pediatrics. Frequently used assessment methods are standardized tests and observational tools such as check-lists, rating scales, and anecdotal reports. The majority of respondents who use standardized tests are satisfied with them. The aspects of the tests most familiar to the respondents are scoring and administration procedures as compared to reliability and validity information. The majority of respondents who use tests, conduct test evaluation procedures. The results are discussed with their implications for training, practice and further research in occupational therapy.

Privatization of Social Services: Time to Move the Debate along

In 'Privatized Social Service Systems: Are There Any Justifications,' Douglas McCready (1986) purports to refute arguments I made in an earlier article (Hurl, 1984) which explored the usefulness of the theory of Interest-Group Liberalism (Lowi, 1969) in understanding the relationships between government and nongovernment service providers, and the persistence of service delivery problems within the heavily privatized Ontario children's services system. Unfortunately, in developing his critique, McCready has lost the gist of my original argument, believing, instead, that I argued privatization 'has led to' numerous problems within Ontario children's services, and that these problems can be eliminated by the 'nationalization' of the children's services system. Given this discrepancy, I urge interested readers to gauge the accuracy of McCready's observations after a careful rereading of my earlier work. For the present, and in the interests of furthering debate on the issue of privatization, I shall forego comment on McCready's representation of my work and address the case which he makes for the continuance of privatization. McCready does not articulate the framework in which his views are to be understood. However, three themes run throughout his paper: 1) competition among nongovernment organizations is the most efficient means of distributing social services; 2) voluntary nongovernment organizations are the agencies of choice in a privatized social service system; and 3) monitoring and a good funding formula are the essential requirements for making a privatized system work. These themes correspond with a view of service delivery which conforms to what has elsewhere been defined as a 'quasi-public model' of service provision (Hurl and Tucker, 1986). In such a model, social services are provided through a system comprised of numerous nongovernment organizations which compete for funding and, frequently, for clientele. Services in this system can be purchased directly by consumers or, for those lacking their own resources, acquired with government or charitable vouchers, cash transfers or service credit cards. Most services, however, are provided through third party purchase of service contracts whereby government makes direct payments to service organizations for the provision of agreed-upon services to consumers. In such an arrangement, government functions as the major purchaser of services in a market which consists of competing nongovernment service suppliers. McCready's vision of a privatized system is one version of the foregoing model. The primary point of distinction is that the competing nongovernment organizations are voluntary as

Privatized Social Service Systems: Lessons from Ontario Children's Services

Privatized Social Service Systems: Lessons from Ontario Children's Services

Survey of the intelligence of cleft-lip and cleft-palate children in Ontario.

International Journal of Language & Communication DisordersVolume 6, Issue 1 p. 17-25 SURVEY OF THE INTELLIGENCE OF CLEFT-LIP AND CLEFT-PALATE CHILDREN IN ONTARIO Ruth Lewis M.A., L.C.S.T., Ruth Lewis M.A., L.C.S.T. Cleft Lip and Cleft Palate Research and Treatment Centre, The Research Institute of The Hospital for Sick Children, Toronto, Canada.Search for more papers by this author Ruth Lewis M.A., L.C.S.T., Ruth Lewis M.A., L.C.S.T. Cleft Lip and Cleft Palate Research and Treatment Centre, The Research Institute of The Hospital for Sick Children, Toronto, Canada.Search for more papers by this author First published: April 1971 https://doi.org/10.3109/13682827109011521Citations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume6, Issue1April 1971Pages 17-25 RelatedInformation

The Statistics of the Samaritan Free Hospital

<h3>Background:</h3> There were large disruptions to health care services after the onset of the COVID-19 pandemic. We sought to describe the extent to which pandemic-related changes in service delivery and access affected use of primary care for children overall and by equity strata in the 9 months after pandemic onset in Manitoba and Ontario. <h3>Methods:</h3> We performed a population-based study of children aged 17 years or less with provincial health insurance in Ontario or Manitoba before and during the COVID-19 pandemic (Jan. 1, 2017–Nov. 28, 2020). We calculated the weekly rates of in-person and virtual primary care well-child and sick visits, overall and by age group, neighbourhood material deprivation level, rurality and immigrant status, and assessed changes in visit rates after COVID-19 restrictions were imposed compared to expected baseline rates calculated for the 3 years before pandemic onset. <h3>Results:</h3> Among almost 3 million children in Ontario and more than 300 000 children in Manitoba, primary care visit rates declined to 0.80 (95% confidence interval [CI] 0.77–0.82) of expected in Ontario and 0.82 (95% CI 0.79–0.84) of expected in Manitoba in the 9 months after the onset of the pandemic. Virtual visits accounted for 53% and 29% of visits in Ontario and Manitoba, respectively. The largest monthly decreases in visits occurred in April 2020. Although visit rates increased slowly after April 2020, they had not returned to prerestriction levels by November 2020 in either province. Children aged more than 1 year to 12 years experienced the greatest decrease in visits, especially for well-child care. Compared to prepandemic levels, visit rates were lowest among rural Manitobans, urban Ontarians and Ontarians in low-income neighbourhoods. <h3>Interpretation:</h3> During the study period, the pandemic contributed to rapid, immediate and inequitable decreases in primary care use, with some recovery and a substantial shift to virtual care. Postpandemic planning must consider the need for catch-up visits, and the long-term impacts warrant further study.