Childhood Health Assessment Research Articles

The interRAI Child and Youth Suite of Mental Health Assessment Instruments: An Integrated Approach to Mental Health Service Delivery.

Various biological, social, psychological, and environmental factors impact children and youth living with mental health problems across their lifespan. To meet the wide-ranging challenges of mental illness, service system integration is needed to improve efficiencies and reduce fragmentation. Unfortunately, the mental health system has been plagued by the lack of coordination across services. There is a general consensus that mental health service delivery must ensure a child or youth’s needs are addressed in a collaborative, coordinated, and seamless manner. A key element to successful integration is the development of a comprehensive standardized screening and assessment system. Numerous assessments have been developed to assess child mental health and functioning, but they typically have a very narrow focus with limited use and utility. Not only does this reduce the ability to take a life course perspective to mental health, but this uncoordinated approach also results in redundancies in information collected, additional resources, and increased assessor burden for children, youth, and their families. The interRAI child and youth mental health assessment suite was developed in response to the need for an integrated mental health system for young persons. This suite includes screening and assessment instruments for in-patient and community settings, emergency departments, educational settings, and youth justice custodial facilities. The instruments form a mental health information system intentionally designed to work in an integrated fashion beginning in infancy, and incorporate key applications such as care planning, outcome measurement, resource allocation, and quality improvement. The design of these assessment tools and their psychometric properties are reviewed. Data is then presented using examples related to interpersonal trauma, illustrating the use and utility of the integrated suite, along with the various applications of these assessment systems.

Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis

BackgroundSocial determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.MethodsIn this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.ResultsOne thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.ConclusionHigh community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

Investigating health adversity and school engagement among clinically referred children and youth using the interRAI Child and Youth Mental Health Assessment

Students faced with health problems are often disadvantaged with respect to many educational outcomes. Social skills and personal strengths can support school engagement and promote educational success. Utilizing the interRAI Child and Youth Mental Health assessment system, the present study investigated how relational and individual strengths may mitigate the distressing impact of physical and mental health concerns on school engagement among 8218 clinically referred elementary and secondary school students. Findings confirmed that the presence of significant physical and mental health distress is associated with greater school engagement problems among students. Further, individual and relational strengths were found to be associated with school engagement among both children and youth. Among school-age children (ages 4–11 years), school engagement problems were predicted by male sex, older age, medical problems, internalizing symptoms, externalizing problems, and relational problems. Relatedly, school engagement problems were predicted among youth (ages 12–18 years) by male sex, sleep problems, externalizing problems, low individual strengths, and relational problems. Considerations for promoting school engagement within the school context through an emphasis on relational and individual skills development are provided.

Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications

It remains unknown whether SARS-CoV-2 infection specifically increases the risk of serious obstetric morbidity. To evaluate the association of SARS-CoV-2 infection with serious maternal morbidity or mortality from common obstetric complications. Retrospective cohort study of 14 104 pregnant and postpartum patients delivered between March 1, 2020, and December 31, 2020 (with final follow-up to February 11, 2021), at 17 US hospitals participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Gestational Research Assessments of COVID-19 (GRAVID) Study. All patients with SARS-CoV-2 were included and compared with those without a positive SARS-CoV-2 test result who delivered on randomly selected dates over the same period. SARS-CoV-2 infection was based on a positive nucleic acid or antigen test result. Secondary analyses further stratified those with SARS-CoV-2 infection by disease severity. The primary outcome was a composite of maternal death or serious morbidity related to hypertensive disorders of pregnancy, postpartum hemorrhage, or infection other than SARS-CoV-2. The main secondary outcome was cesarean birth. Of the 14 104 included patients (mean age, 29.7 years), 2352 patients had SARS-CoV-2 infection and 11 752 did not have a positive SARS-CoV-2 test result. Compared with those without a positive SARS-CoV-2 test result, SARS-CoV-2 infection was significantly associated with the primary outcome (13.4% vs 9.2%; difference, 4.2% [95% CI, 2.8%-5.6%]; adjusted relative risk [aRR], 1.41 [95% CI, 1.23-1.61]). All 5 maternal deaths were in the SARS-CoV-2 group. SARS-CoV-2 infection was not significantly associated with cesarean birth (34.7% vs 32.4%; aRR, 1.05 [95% CI, 0.99-1.11]). Compared with those without a positive SARS-CoV-2 test result, moderate or higher COVID-19 severity (n = 586) was significantly associated with the primary outcome (26.1% vs 9.2%; difference, 16.9% [95% CI, 13.3%-20.4%]; aRR, 2.06 [95% CI, 1.73-2.46]) and the major secondary outcome of cesarean birth (45.4% vs 32.4%; difference, 12.8% [95% CI, 8.7%-16.8%]; aRR, 1.17 [95% CI, 1.07-1.28]), but mild or asymptomatic infection (n = 1766) was not significantly associated with the primary outcome (9.2% vs 9.2%; difference, 0% [95% CI, -1.4% to 1.4%]; aRR, 1.11 [95% CI, 0.94-1.32]) or cesarean birth (31.2% vs 32.4%; difference, -1.4% [95% CI, -3.6% to 0.8%]; aRR, 1.00 [95% CI, 0.93-1.07]). Among pregnant and postpartum individuals at 17 US hospitals, SARS-CoV-2 infection was associated with an increased risk for a composite outcome of maternal mortality or serious morbidity from obstetric complications.

Substance Use among Youth in Community and Residential Mental Health Care Facilities in Ontario, Canada.

There is a need to improve the integration of substance use and mental health care for children and youth. This study examines risk and protective factors for substance use among youth with mental health conditions who received community-based or residential care services between 2012–2020 in Ontario, Canada. In this study, a cross-sectional design was used to examine patterns and factors associated with substance use among youth (12–18 years) assessed in the community (n = 47,418) and residential (n = 700) mental health care facilities in Ontario, Canada. Youth were assessed with the interRAI Child and Youth Mental Health Assessment (ChYMH). Substance use is identified by any substance use (including alcohol) 14 to 30 days prior to assessment. Logistic regression with generalized estimating equations was used to examine clinical, psychosocial, and environmental factors associated with substance use. This study shows that 22.3% of youth reported the use of substances in the community settings and 37% in residential settings. Older age group (Youth older than 16 years), being a victim of abuse, having experienced self-injurious ideation/attempt, being at risk of disrupted education, and having a parent/caregiver with addiction or substance use disorder were significantly associated with substance use. Several factors reduced the risk of substance use, including being a female, having anxiety symptoms, and having cognition problems. In conclusion, the study found that individual and parental factors increase youth’s risk of substance use, highlighting the importance of a holistic approach that includes consideration of social and biological risk factors to prevention/risk reduction, risk assessment, management, and recovery.

Enhancing interprofessional practice through the co-design of a holistic culturally and developmentally informed First Nations child health assessment.

This qualitative study explored staff experiences of co-designing and implementing a novel interprofessional (IP) First Nations child health assessment (the helpful check), developed in partnership with a remote North-Queensland Aboriginal CommunityControlled Health Organisation. Eleven staff across two teams (family health and allied health) were involved in co-designing and implementing the child health assessment and associated IP practices. Interviews were undertaken using a semi-structured interview template and were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Three overarching themes were developed: (1) connect teams by building strong relationships; (2) leave space for helpful check processes to evolve; and (3) integrate helpful check processes into routine practice to sustain change. Results demonstrate how the incorporation of IP practices into a remote primary healthcare setting led to perceived benefits for both the health service staff and clients.

Nurture Intervention on Neurodevelopmental Outcome among Pre-term Neonates

With scientific advances, the survival rate of pre-term babies has increased from 50% to 85%, but the quality of life, morbidity status and neurodevelopment outcomes still remain questionable. A high-quality mother–infant interaction facilitates the child's socio-emotional, behavioural, cognitive and physical development. Fostering nurture-maternal touch, eye-to-eye contact, vocal soothing, odour exchange and Kangaroo Mother Care, to those born too soon and are within neonatal intensive care unit (NICU) constraints forms the background of the research. This article demonstrates how Kathryn E Barnard's Child health assessment interaction model is applied to a nursing research that aims at understanding the effect of nurture on neurodevelopmental outcomes of pre-term neonates admitted to the NICU of a tertiary care hospital. The four main concepts of the model are discussed in terms of interdependency on each other. The theory also brings to the forefront the influence of each component on the outcome.

The state of physical functionning of patients with juvenile idiopathic arthritis in the assessment of quality of life

Summary. Juvenile idiopathic arthritis is a severe chronic childhood disease that affects not only the joints but is also accompanied by various comorbid conditions, among which eye damage (uveitis) is the most common. In addition to a significant impact on the general condition of the child, this disease also affects the main indicators of quality of life: physical activity, emotional activity, activity in educational institutions, and the social sphere. During the period of active study of Juvenile idiopathic arthritis patients quality of life, a decrease in its overall level is noted due to almost all components, but physical activity shows the lowest values in some studies, which is associated with joint damage, activity, and duration of the disease. Objective. To determine the state of physical functioning and assess the overall level of quality of life in patients with JIA, considering the subtype of the disease duration and the therapy complex. Materials and Methods. The study was carried out at SI "Institute for Children and Adolescents Health Care of the NAMS of Ukraine", Kharkiv, from November 2020 till November 2021. There 118 patients with juvenile idiopathic arthritis were examined, including 47 with polyarticular, 43 with oligoarticular, 28 with uveitis-associated subtypes. The investigation involved 77 girls and 41 boys in age from 2 till 18 years old. The therapy by methotrexate was provided in 111 patients, among them 30 had methotrexate with immunobiological therapy (29 adalimumab, 1 – tocilizumab), 6 – sulfasalazine. The disease duration due to disease subtype was in children with polyarthritis – (49,2±6,7), oligoarthritis – (35,4±4,2), uveitis-associated subtypes of juvenile idiopathic arthritis – (76,8±10,2) months. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score 27-joint reduced count questionnaire, functional state according to he Child Health Assessment Questionnaire and quality of life according to PedsQLTM 4.0 Generic Core Scales. Results. It was found that high juvenile idiopathic arthritis activity was observed in 31 (26.2%) patients, equally often in all subgroups of children. Index functional state did not show a significant decrease either in the whole group or in each of the arthritis subgroups. The overall indicator of quality of life in children with juvenile idiopathic arthritis was reduced in the whole group (71.2±1.4 and 72.9±1.4 per week and month). There was no significant difference between the quality of life indicators of boys and girls. at the same time, physical activity indicators were the lowest in the group with polyarticular juvenile idiopathic arthritis, regardless of gender and age of children, and especially low in children with polyarthritis in the first year of the disease. They also turned out to be worse in children with uveitis-associated subtypes of juvenile idiopathic arthritis with the disease from one to three years. The highest level of the physical component of quality of life was observed in children with oligoarthritis older than 14 years and in children under 8 years of age in the uveitis-associated subtypes of juvenile idiopathic arthritis group. There was no significant effect on the physical indicators of quality of life of the start treatment timing. (р≤0,05). Conclusions. A decrease in quality of life and its physical component is typical for children with different types of juvenile idiopathic arthriti (oligoarticular, polyarticular, and uveitis-associated subtypes of juvenile idiopathic arthritis). It has been established that children with polyarticular subtype of arthritis have the greatest decrease in quality of life and physical functioning.

Indian Academy of Pediatrics Guidelines on Screen Time and Digital Wellness in Infants, Children and Adolescents

Screen-based media have become an important part of human lifestyle. In view of their easy availability and increasing use in Indian children, and their excessive use being linked to physical, developmental and emotional problems, there is a need to develop guidelines related to ensure digital wellness and regulate screen time in infants, children, and adolescents. To review the evidence related to effects of screen-based media and excessive screen time on children's health; and to formulate recommendations for limiting screen time and ensuring digital wellness in Indian infants, children and adolescents. An Expert Committee constituted by the Indian Academy of Pediatrics (IAP), consisting of various stakeholders in private and public sector, reviewed the literature and existing guidelines. A detailed review document was circulated to the members, and the National consultative meet was held online on 26th March 2021 for a day-long deliberation on framing the guidelines. The consensus review and recommendations formulated by the Group were circulated to the participants and the guidelines were finalized. Very early exposure to screen-based media and excessive screen time (>1-2h/d) seems to be widely prevalent in Indian children. The Group recommends that children below 2 years age should not be exposed to any type of screen, whereas exposure should be limited to a maximum of one hour of supervised screen time per day for children 24-59 months age, and less than two hours per day for children 5-10 years age. Screen time must not replace other activities such as outdoor physical activities, sleep, family and peer interaction, studies and skill development, which are necessary for overall health and development of the children and adolescents. Families should ensure a warm, nurturing, supportive, fun filled and secure environment at home, and monitor their children's screen use to ensure that the content being watched is educational, age-appropriate and non-violent. Families, schools and pediatricians should be educated regarding the importance of recording screen exposure and digital wellness as a part of routine child health assessment, and detect any signs of cyberbullying or media addiction; and tackle it timely with expert consultation if needed.

National Nutrition and Health Systematic Survey for Children 0–17 Years of Age in China

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC) was to collect basic data on the nutrition, development, and health status for children in different regions across China using evidence-based, reliable, and cost-effective approaches. Children and their parents or guardians from seven regions (south, southwest, north, northwest, eastern, central, and northeast China) in China were recruited. A multi-stage stratified randomized sampling method was used. Two provinces were randomly sampled from each of the seven regions, from which one urban district and one rural country were also randomly sampled, resulting in a total of 28 survey counties/districts. Dietary surveys, health examinations, laboratory testing, and questionnaires were used to collect dietary intake, nutritional status, child development, and health status information. Nutrition, health, and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice (KAP) survey. Greater than 100,000 children (38,000 children < 6 years of age and 66,000 children 6-17 years of age) completed the survey. The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

School Disengagement and Mental Health Service Intensity Need Among Clinically Referred Students Utilizing the interRAI Child and Youth Mental Health Assessment Instrument.

Although mental health challenges are widespread, impacting 1 in 5 children and youth, only 25% of these young people receive the required mental health supports. Unmet mental health needs are strongly associated with functional impairments including poor self-care, interpersonal challenges, and school difficulties among young people. School disengagement, or a student's lack of involvement in education through interest, curiosity, motivation, and active participation, is associated with a wide array of detrimental outcomes including chronic mental health difficulties, conduct and delinquent behaviors, criminal justice involvement, and unemployment in adolescence and adulthood. Disengagement observed within the school setting may be indicative of underlying mental health challenges and reflective of service intensity need. The current study extends the literature by examining the relationship between school disengagement and mental health service intensity need among 14,750 clinically referred students across elementary and secondary school utilizing the interRAI Child and Youth Mental Health instrument. Findings indicated that more than 25% of clinically referred students were at heighted risk for school disengagement and required high-intensity services. Further, mental health service intensity need was positively associated with risk of school disengagement among students, along with the specific reason for referral (i.e., psychiatric symptoms, harm to self, harm to others, or addiction or dependency), after controlling for sex and age. Implications of the findings are explored within the context of the school setting and future directions are suggested.

Mental Health Symptom Profiles of Adolescents in Foster Care.

The article describes an investigation of the nature, patterns and complexity of carer-reported mental health symptoms for a population sample (N = 230) of adolescents (age 12-17) placed in long-term foster and kinship care following chronic and severe maltreatment. Two cluster analyses of Child Behaviour Checklist DSM-oriented (CBCL-DSM) and Assessment Checklist for Adolescents sub-scale scores of clinical cases were performed. The first yielded 8 profiles of attachment- and trauma-related symptoms as measured across eight ACA scales (N = 113 cases). The second yielded 11 profiles of a broader range of symptoms, as measured across five CBCL-DSM and five ACA sub-scales (N = 141 cases). The symptom profiles derived from both cluster analyses are differentiated more by symptom severity and complexity, than by symptom specificity - suggesting that trauma- and attachment-related symptomatology does not conform to a taxonomy of discrete disorders. Five of the 11 CBCL-DSM/ACA profiles describe severe and complex symptomatology that does not correspond to discrete DSM-5 or ICD-11 diagnoses. Accurate measurement and formulation of clinical phenomena is an essential component of evidence-based psychological and psychiatric practice. Clinicians who carry out mental health assessments of children and adolescents in care should be aware of the limits of the diagnostic classification systems for formulating complex attachment- and trauma-related symptomatology.

ICCareD: The Development of an Algorithm to Identify Factors Associated With Distress Among Caregivers of Children and Youth Referred for Mental Health Services.

Caregiver well-being plays an important role in children's development and a number of factors have been found to impact distress levels among caregivers of children and youth referred for mental health services. Further, caregiver distress impacts youth psychopathology, its acuity as well as related mental health interventions. The purpose of this study was to develop and validate an algorithm for identifying caregivers who are at greatest risk of experiencing caregiver distress. This algorithm was derived from, and will be embedded in, existing comprehensive interRAI child and youth instruments. Ontario data based on the interRAI Child and Youth Mental Health assessment instruments (ChYMH and ChYMH-DD) were analyzed to identify predictors of distress among caregivers of children and youth ages 4–18 years. Starting with proactive aggression, the algorithm uses 40 assessment items to assign one of 30 nodes that are grouped into five levels of risk. The interRAI ChYMH Caregiver Distress (iCCareD) algorithm was validated using longitudinal data from mental health agencies across Ontario and was found to be a good predictor among this sample with a c-statistic of 0.71 for predicting new or ongoing caregiver distress and 65% for both sensitivity and specificity using algorithm values of 3 or greater. This algorithm provides an evidence-based decision-support tool embedded within a comprehensive assessment tool that may be used by clinicians to inform their selection of supports and services for families.

Following the Epidemic Waves: Child and Youth Mental Health Assessments in Ontario Through Multiple Pandemic Waves.

Emerging studies across the globe are reporting the impact of COVID-19 and its related virus containment measures, such as school closures and social distancing, on the mental health presentations and service utilization of children and youth during the early stages of lockdowns in their respective countries. However, there remains a need for studies which examine the impact of COVID-19 on children and youth's mental health needs and service utilization across multiple waves of the pandemic. The present study used data from 35,162 interRAI Child and Youth Mental Health (ChYMH) assessments across 53 participating mental health agencies in Ontario, Canada, to assess the mental health presentations and referral trends of children and youth across the first two waves of the COVID-19 pandemic in the province. Wave 1 consisted of data from March to June 2020, with Wave 2 consisting of data from September 2020 to January 2021. Data from each wave were compared to each other and to the equivalent period one year prior. While assessment volumes declined during both pandemic waves, during the second wave, child and youth assessments in low-income neighborhoods declined more than those within high-income neighborhoods. There were changes in family stressors noted in both waves. Notably, the proportion of children exposed to domestic violence and recent parental stressors increased in both waves of the pandemic, whereas there were decreases noted in the proportion of parents expressing feelings of distress, anger, or depression and reporting recent family involvement with child protection services. When comparing the two waves, while depressive symptoms and recent self-injurious attempts were more prevalent in the second wave of the pandemic when compared to the first, a decrease was noted in the prevalence of disruptive/aggressive behaviors and risk of injury to others from Wave 1 to Wave 2. These findings highlight the multifaceted impact of multiple pandemic waves on children and youth's mental health needs and underscore the need for future research into factors impacting children and youth's access to mental health agencies during this time.

Exploring a Role for Parental Mental Health in Perception and Reports of Pain on Behalf of Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) have a higher prevalence of pain compared to those without ASD. Pain is a leading cause of morbidity and disability worldwide and may contribute to adverse health outcomes in people with ASD, thus warranting further research on this special population. The present study used data from 1,423 children with ASD and 46,023 children without ASD and their mothers from the combined 2016-2017 National Survey of Children's Health. Mothers reported child pain and ASD status and their own mental health status. Mothers reporting a status of “Fair or Poor” were considered as having maternal mental health conditions (MMHCs) for the purposes of this study. Children with and without ASD who had mothers with MMHCs had higher odds of pain compared to children with mothers without MMHCs. These increased odds did not attenuate as a result of controlling for co-occurring neurological conditions, which have been associated with increased pain in children with ASD. Thus, parent mental health may alter perception and/or reports of pain on behalf of children with and without ASD. Future research should include more detailed assessments of parent mental health and clinical assessments of children in order to explore the role of parent mental health in the experiences of pain and other symptoms present in children with ASD.

New Milwaukee MH emergency center names its administrator

The new Mental Health Emergency Center, a joint venture between Milwaukee County and the area's four health systems (Advocate Aurora Health, Ascension Wisconsin, Children's Wisconsin and Froedtert Health), announced the selection of a new administrator. Just one component in the broader array of mental health services in Milwaukee County, the emergency center will serve as a national model for emergency crisis care that is patient‐centered, recovery‐oriented and culturally informed, a news release stated. Kevin Kluesner has been selected as the administrator of the new Mental Health Emergency Center, effective Oct. 11. Targeted to open in early 2022, the Mental Health Emergency Center will offer 24/7 crisis mental health assessment, stabilization, treatment and transition care management for children, adolescents and adults. “Our community and our nation's mental health services have long been underfunded and fragmented,” said Kluesner. “This opportunity to help create an innovative mental health emergency center and quickly integrate it into Milwaukee's mental health care continuum will be important and fulfilling work. I'm looking forward to establishing and maintaining strong relationships with the Mental Health Emergency Center's stakeholders and the Milwaukee community.”

309: Expanding the Cystic Fibrosis Foundation’s mental health screening guidelines: Early childhood behavioral health assessment for children with cystic fibrosis aged 4 to 11

309: Expanding the Cystic Fibrosis Foundation’s mental health screening guidelines: Early childhood behavioral health assessment for children with cystic fibrosis aged 4 to 11

Abuse, Mental State, and Health Factors Pre and during the COVID-19 Pandemic: A Comparison among Clinically Referred Adolescents in Ontario, Canada.

Throughout the COVID-19 pandemic, population surveys revealed increased levels of anxiety and depression, while findings from large-scale population data analyses have revealed mixed findings with respect to the mental health consequences for children and youth. The purpose of this study was to examine the impact of the COVID-19 pandemic on the well-being and health-compromising behaviors of adolescents (12–18 years) previously referred for mental health services. Data were collected (pre-pandemic n = 3712; pandemic n = 3197) from mental health agencies across Ontario, Canada using the interRAI Child and Youth Mental Health assessment. Our findings revealed no increased incidence of witnessing domestic violence nor experiencing physical, sexual, or emotional abuse. Further, there were no increases in the risk of self-harm and suicide, anxiety, or depression among our sample of clinically referred youth. Finally, results demonstrated no increase in problematic videogaming/internet use, disordered eating, or alcohol intoxication, and a decrease in cannabis use. Our findings add to the growing body of knowledge as to the impact of the COVID-19 pandemic on children and youth. Further, findings underscore the importance of understanding the nuanced impact of the pandemic on various subgroups of children, youth, and families and highlight the need for continued monitoring of outcomes for these children and youth.

Ефективність оцінки якості життя в дітей із суглобовим синдромом у практиці сімейного лікаря

Метою роботи було вивчити якість життя дітей із проявами суглобового синдрому та обґрунтувати необхідність введення методики оцінки якості життя в практику сімейного лікаря. Матеріали та методи. Обстежено 60 хворих на ювенільний ревматоїдний артрит, 28 хворих на реактивний артрит та 30 здорових дітей. Якість життя дітей із суглобовим синдромом визначали шляхом анкетування їх батьків за допомогою опитувальників Child Health Questionnaire (CHQ) та Child Health Assessment Questionnaire (CHAQ). Результати. Встановлено, що ювенільний ревматоїдний артрит викликав погіршення фізичного та психосоціального здоров’я, тоді як дітям із реактивним артритом були притаманні проблеми лише фізичного характеру (p &lt; 0,05). Опитувальники CHQ та CHAQ є ефективними, простими й зручними в користуванні інструментами оцінки впливу суглобового синдрому на якість життя хворих дітей. Висновки. Погляд дитини та її батьків на хворобу дозволить сімейному лікарю детальніше оцінити стан здоров’я кожного окремо взятого пацієнта, що, у свою чергу, дасть змогу своєчасно прийняти рішення про подальшу тактику ведення хворого. Окрім цього, вивчення якості життя дітей із суглобовим синдромом дозволить сімейному лікарю легко виділити тих хворих, які в першу чергу потребують кваліфікованої психологічної допомоги.

Using Digital Stories for assessments and transition planning for autistic pre-school children

Aims:‘I am…’ Digital Stories are short videos designed to provide a holistic, strengths-based representation of the child through enabling them to contribute their perspectives to transition planning. Digital Stories have potential during periods in which professionals are unable to physically visit settings or spend time getting to know a child. This paper describes the use of Digital Stories in two contexts: (1) being shown at the beginning of person-centred planning meetings focusing on the transition to primary school; and (2) as a tool to support educational psychologists conducting Education, Health, and Care Needs Assessments for preschool children during Covid-19.Method:Data was collected via seven semi-structured interviews, 15 feedback forms, and videos of four meetings. Participants comprised six parents/carers, five nursery practitioners, three school staff members, and six educational psychologists. Thematic analysis resulted in five main themes: thinking differently; a wider conversation; more than words; seeing what they see; and potential barriers to making Digital Stories.Limitations:Children were not able to make their own Digital Stories, which could have influenced their representation within the videos, transition meetings and assessments. However, children’s body worn camera footage was included, enabling a perspective on their interactions and preferences that was closer to the child’s worldview than other observational methods.Conclusions:Digital Stories have a variety of benefits to practice, including being useful to educational psychologists during assessments, and have the potential to facilitate successful transitions from nursery to primary school.