Emotional Health Of Children Research Articles

Profiles of children's social–emotional health at school entry and associated income, gender and language inequalities: a cross-sectional population-based study in British Columbia, Canada

ObjectivesEarly identification of distinct patterns of child social–emotional strengths and vulnerabilities has the potential to improve our understanding of child mental health and well-being; however, few studies have explored natural...

Emotional health in children and adolescents with cystic fibrosis.

Although modern therapeutic procedures have considerably improved the survival and the quality of life of children with cystic fibrosis, the relevant psychological aspects have been still insufficiently considered similarly to the other chronic diseases. The aim of this research was to evaluate the emotional health: psychological characteristics and adjustment of CF children and their family coping. The study comprises 25 CF children, mean age 13.13 ± 2.29 years (23 boys and only 2 girls), selected from total 60 actually treated children for CF. Children were examined in the period of improved health conditions (without superinfection, wheezing or gastrointestinal problems). Obtained results are compared with a control group of 25 healthy children of the same age, selected by random from primary schools. The psychometric instruments used were: Kohs Design Test, Child Behavior Checklist, Eysenck Personality Questionnaire, General Anxiety Scale, Emotional Profile Index, MMPI-201 and Human Values Test, together with two projective tests of drawing (Machover and Corman). The unexpected good psychological results obtained from psychometric instruments could be explained by the fact that CF children accept the real situation and express vivacity. However, their deep feelings of fear impose on them high level of self-control and resistance. The results obtained for CBCL presented CF children as immature, with accentuated aggressiveness in interpersonal relations. The most important problem is related to the delay of puberty changes, leading to low self-esteem. Generally, family members cope relatively well with the disease in children, in spite to discrepancies in mother/child reports for child psychopathology. Divorces also occurred in some families. Psychological support for both, children and family members are necessary. The need for a holistic approach in the assessment and treatment, including biofeedback techniques was pointed out.

Paternal Mental Health: Why Is It Relevant?

Father's mental health is an emerging area of interest that is beginning to be recognized in research, and to a lesser extent in clinical practice and society. Fathers are part of a parenting dyad with 2 partners who are responsible for their children's emotional development. Similar to mothers, the risk for mental health problems increases once a male becomes a father, but there is limited research examining this issue. The purpose of this review is to present the available literature on father's mental health and its effect on child emotional health through various mechanisms. In general, father's mental health was found to be related to increased child internalizing and externalizing behaviors, but each disorder had different risk factors, and a unique effect on parenting behaviors and the child's emotional health. The most developed paternal mental health literature is focused on depression. However, key conceptual and methodological problems exist that may limit our understanding of paternal depression. Additionally, the focus on paternal depression may not accurately represent the largest risk for paternal psychopathology and the resultant child mental health outcomes because men have an increased likelihood of displaying externalizing behaviors. Implications for research, clinical practice, and policy are discussed.

Self reported behavioral and emotional difficulties in relation to dentition status among school going children of Dilsukhnagar, Hyderabad, India.

Oral health has strong biological, psychological, and social projections, which influence the quality of life. Thus, developing a common vision and a comprehensive approach to address children's social, emotional, and behavioral health needs is an integral part of the child and adolescent's overall health. To assess and compare the behavior and emotional difficulties among 15-year-olds and to correlate it with their dentition status based on gender. Study Settings and Design: A cross-sectional questionnaire study among 15-year-old schoolgoing children in six private schools in Dilsukhnagar, Hyderabad, India. The behavior and emotional difficulties were assessed using self-reported Strengths and Difficulties Questionnaire (SDQ). The dentition status was recorded by the criteria given by the World Health Organization (WHO) in the Basic Oral Health Survey Assessment Form (1997). Independent Student's t-test was used for comparison among the variables. Correlation between scales of SDQ and dentition status was done using Karl Pearson's correlation coefficient method. Girls reported more emotional problems and good prosocial behavior and males had more conduct problems, hyperactivity, peer problems, and total difficulty problems. Total decayed-missing-filled teeth (DMFT) and decayed component were significantly and positively correlated with total difficulty, emotional symptom, and conduct problems scale while missing component was correlated with the hyperactivity scale and filled component with prosocial behavior. DMFT and its components showed an association with all scales of SDQ except for peer problem scale. Thus, the oral health of children was significantly influenced by behavioral and emotional difficulties; so, changes in the mental health status will affect the oral health of children.

Effects of an insect-mediated mental healthcare program for mentally disordered children

Insects are the most diverse groups of animals on the planet, representing more than one-half of all known living organisms, and are found in nearly every environment. Recently, the importance of insects as food sources or as pets has increased in many countries, including Korea. In addition, several insects have been shown to exert a strong influence on people's emotions. Our insect-mediated mental healthcare program is designed to help meet the physical, behavioral and developmental needs of people with mental disorders. Children with mental disorders, the experimental group, were provided with an insect-mediated mental healthcare program for a total of eight sessions, one session per week, at 1–2 h per session, accompanied by a pre-test and post-test. The overall, gender, education level, and mental disease profiles of the participants in this study were balanced. Our results indicated that children who participated in the insect-mediated healthcare program group once showed significant improvement in their emotional health and insect awareness. Additionally, paired education level's t-tests showed that the outcomes of the participants in treatment group were significantly improved (α < 0.05). However, participants' satisfaction with their school life (middle school) was not influenced. These results suggest that insects positively influence children's emotional health through an insect-mediated healthcare program. Further research on the basis of this study is expected to help children with emotional therapy in other areas.

Challenges for Refugee Children at School in Eastern Turkey

IntroductionThe increasing traffic of international population flows to Turkey and through Turkey warrants more research as well as policies in regards to various migrant groups in the country. It is possible to claim that Turkey has become a destination country over the last decade or so (Sirkeci et al., 2015a; Sirkeci et al., 2012). Despite the fact that recent arrival of Syrian refugees in large numbers, Turkey have seen significant number of refugee arrivals in the past (Yazgan et al., 2015). Among the mover1 groups in Turkey, refugee children are a priority vulnerable group as in other parts of the world (Matthews, 2008; Russell, 1999; Sourander, 1998). The share of children among refugees have increased significantly in recent years and it was reported that 51% of refugees were younger than 18 in 2014 (Battle, 2014; UNHCR, 2015). Turkey's geographical proximity to both Europe and conflict zones in the neighbourhood makes it an attractive transit country as well as a destination due to its relatively stable economy and politics.In this paper, we hope to shed light on the problems encountered by refugee children who are more vulnerable than their parents. Teachers' perspectives are important as they are able to observe a large number of refugee children and their parents particularly in locations where refugee population are concentrated.According to the United Nations High Commissioner for Refugees (UNHCR), there were 19.5 million refugees worldwide by the end of 2014 while the total number of internally and internationally displaced (total population of concern) stood at 59.5 million (UNHCR, 2015). About 51% of the total refugee population in the world are children (younger than 18) (UNHCR, 2015). The total number of asylum seekers and refugees in Turkey, excluding registered Syrians (2.1 million), who are not considered officially as refugees, was 218,652 by the end of September 2015 (UNHCR Turkey, 2015a and 2015b). Other main refugee groups in Turkey are Afghans, Iraqis and Iranians. While a gender balanced population is evident, about one third of non-Syrian refugees and nearly half of Syrian refugees are aged under 18 and three thirds of these are at school ages (UNHCR Turkey, 2015b; AFAD, 2013). These numbers show that the number of children among refugees in Turkey has risen from 6,027 in 2009 to 8,743 in 2012 and to over 1.1 million in 2015 among whom only 20,619 are officially recognized refugees. These statistics show the importance of understanding this vulnerable group's needs and wants.Van is geographically and socio-economically an interesting province influenced by internal and international migration flows and since it borders with Iran, there is a concentration of refugee traffic of mainly Iranians and Afghans. Like in many other countries, these groups stay in Van until their legal statuses are determined, which sometimes is very lengthy and warrants significant level of settlement and engagement with local communities. Differences and similarities become central in this peculiar process of acculturation as defined by Berry (2002). Acculturation stress is known to have adverse effects on children's mental and emotional health (Fine and Sirin, 2007). Educational needs are essential for those refugees under 18 and their access to education paves the way for more optimistic outlook in life (Fazel et al., 2012). Education gives an opportunity to refugee children to engage with the local community while also enabling native populations to know refugees. This process is sometimes marked by difficulties and tensions. These difficulties are explored in this study from the perspective of teachers involved in education of refugee children in Van province.1. Education for Refugee childrenProblems faced at early stages of education are known to have risks of causing life time concerns in individuals' lives. Despite national and international obligations for the state to offer education to children, refugee children largely face difficulties in accessing basic education (IHAD, 2011). …

How Does Household Income Affect Child Personality Traits and Behaviors?

We examine the effects of a quasi-experimental unconditional household income transfer on child emotional and behavioral health and personality traits. Using longitudinal data, we find that there are large beneficial effects on children's emotional and behavioral health and personality traits during adolescence. We find evidence that these effects are most pronounced for children who start out with the lowest initial endowments. The income intervention also results in improvements in parental relationships which we interpret as a potential mechanism behind our findings.

The joy of being green

Dr Susan Davis explores why, in our modern electronic world, it is still essential for children's wellbeing and emotional health that we foster resilience through promoting more opportunities for outdoor play.

Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care

The current state of science suggests that safe, responsive, and nurturing parent-child relationships early in children's lives promotes healthy brain and child development and protection against lifelong disease by reducing toxic stress and promoting foundational social-emotional health. Pediatric health care providers (HCPs) have a unique opportunity to foster these relationships. However, such a role requires a shift in pediatric health care from a focus only on children to one that includes families and communities, as well as the inclusion of children's social and emotional health with their physical health. To foster healthy parent-child relationships, HCPs must develop the expertise to integrate approaches that support the family's socioemotional health into pediatric primary care. This article suggests ways in which pediatric HCPs can integrate a focus on parental reflective functioning into their clinical work, helping parents to understand some of the thoughts and feelings that underlie their children's behavior.

Building the capacity of care-givers to improve children's Emotional Wellbeing: A case study of an orphanage in Pakistan

The paper introduced Aangan, a project focussing on children's emotional health in Pakistan, as part of Rozan, an NGO. As part of Aangan's life skills work, it developed and implemented a project with a children's institution, an orphanage for children who had been orphaned, abandoned or separated from their families. Based on concepts of emotional intelligence (EQ), self-awareness, life skills and vulnerability, the project aimed to support resident children's development and wellbeing through assisting the management to establish systems and policies, sensitising its staff to children's emotional health issues and training them to run group sessions with children. The project ran as three phases: sensitisation workshops; building staff capacity; and project assessment. The project brought out a range of issues such as abuse, trauma, anger, anxiety, behavioural difficulties, etc. The feedback received regarding the workshops, training and groups was very positive, and assessments showed promising trends.

WHAT PREDICTS A SUCCESSFUL LIFE? A LIFE-COURSE MODEL OF WELL-BEING.

Policy-makers who care about well-being need a recursive model of how adult life-satisfaction is predicted by childhood influences, acting both directly and (indirectly) through adult circumstances. We estimate such a model using the British Cohort Study (1970). We show that the most powerful childhood predictor of adult life-satisfaction is the child's emotional health, followed by the child's conduct. The least powerful predictor is the child's intellectual development. This may have implications for educational policy. Among adult circumstances, family income accounts for only 0.5% of the variance of life-satisfaction. Mental and physical health are much more important.

Emotional health and wellbeing CPD for school nurses

The emotional health and wellbeing of children and young people is a significant public health issue. If figures of mental health disorders continue to rise at their current rate, by 2020 mental ill health may become one of five leading causes of childhood illness, disability and death (WHO, 2004). While it is not definitive why this public health issue continues to rise, several triggers have been associated with the deterioration in mental health in young people. These triggers include: pressure to achieve educationally, perfection relating to body image, consumerism, competition for jobs in a rising unemployment market, family breakdown and access to social media 24-hours a day (Young Minds, 2014). Furthermore it has been found that the adult brain does not fully develop until the age of 25 years thus creating a combination of factors, which make young people susceptible to developing mental health issues during this formative stage. Consequently this has led to a paradigm shift in the school nursing service over the last decade, with an ever increasing focus on the emotional health of children and young people. School nurses are involved in a range of complex psychological and emotional disorders; for example, with children as young as 5 experiencing anxiety and/or displaying signs of conduct disorder through to adolescents with eating disorders, who deliberately self-harming and/or with depression. Nonetheless school nurses are in a unique position to identify, support and manage children and young people with their emotional health through their public health role, which involves early intervention, health prevention and education (Haddad et al, 2010) across all service levels from Universal to Universal Partnership Plus (Department of Health (DH), 2012a).

환경적 요인이 아동 성장기의 정신건강에 미치는 영향

우울감과 불안감은 새로운 환경에 익숙하지 못한 사람들에게서 나타나는 일반적인 정서경험이며, 이것이 원인이 되어 인지장애, 정서장애, 행동장애를 야기 할 수 있다. 이러한 장애요인은 학업에 대한 집중력을 저하시키고 폭력성을 증가시켜 개인과 사회에 심각한 손실을 끼친다. 특히 아동들의 정서적 발달과정에서 정신건강은 매우 중요한 요소이다. 부모나 집단으로 부터의 학대나 피해는 우울감과 불안감을 야기해 개인의 정상적인 성장과정에 걸림돌이 되고 있고, 공격적인 성향이 증가되어 비행으로 발전도 할 수 있다. 본 연구는 이러한 이론적 배경을 근거로 아동들의 성장과정에서 부모나 집단으로 부터의 폭력이 얼마나 심각하게 아동정서에 영향을 미치는가를 구조방정식 모형을 통하여 분석하였다. A child's mental health is an important element of his proper emotional development. Abuse of children by parents and peer groups are causes of depression and anxiety in children. These conditions become obstacles to their normal growth process which can be a contributing factor to juvenile delinquency. This study is based in the theoretical background of the relationship between abuse from parents and peer groups and children's emotional health. This information is analyzed through structural equation modeling.

Predictors of meeting physical activity and fruit and vegetable recommendations in 9-11-year-old children.

Childhood obesity represents a significant public health problem. This study examined physical activity and nutrition behaviours and attitudes of 9-11-year-olds, and factors influencing these behaviours. Study participants recorded pedometer steps for 7 days and completed physical activity enjoyment, food attitudes and food frequency questionnaires. Fruit and vegetable sales data were collected from schools. The setting for the study was elementary schools in metropolitan Denver, Colorado (USA). Logistic regression was used to determine significant predictors of meeting physical activity/fruit and vegetable intake recommendations. Overall, 42.0% of boys and 44.1% of girls met step count recommendations. Further, 30.9% of boys and 32.8% of girls met step count requirements associated with low risk for overweight/obesity. Enjoyment of physical activity significantly predicted achieving recommendations. Overall, 66.4%, 51.3% and 65.8% of 9-11-year-olds achieved adequate fruit, vegetable, or fruit and vegetable intake, respectively. Enjoyment of fruit/vegetable consumption, perceived parental intake and encouragement and cups of vegetables purchased predicted achieving adequate intake. The majority of young people aged 9-11 years failed to meet step count recommendations to prevent the risk for overweight/obesity. A significant proportion also failed to achieve adequate fruit and/or vegetable intake. Future programmes and interventions should affect multiple environments in order to improve child enjoyment of physical activity and fruit/vegetable intake in order to improve the physical, mental and emotional health of children.

The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review

Serious parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents. Improving the lives of these children is a political and public health concern. To conduct an evidence synthesis of the clinical effectiveness, cost-effectiveness and acceptability of community-based interventions for improving QoL in children of parents with serious mental illness (SMI). Nineteen health, allied health and educational databases, searched from database inception to May 2012, and supplemented with hand searches, reference checking, searches of grey literature, dissertations, ongoing research registers, forward citation tracking and key author contact. Inclusion criteria required≥50% of parents to have SMI or severe depression confirmed by clinical diagnosis or baseline symptoms. Children were ≤18 years of age. Community-based interventions included any non-residential psychological/psychosocial intervention involving parents or children for the purposes of improving health or well-being. Intervention comparators were not predefined and primary outcomes were validated measures of children's QoL and emotional health. Secondary outcomes were derived from UK policy and stakeholder consultation. Data were extracted independently by two reviewers and the study quality was assessed via Cochrane criteria for randomised/non-randomised designs, Critical Appraisal Skills Programme (CASP) qualitative criteria or a standard checklist for economic evaluations. Separate syntheses were conducted for SMI and severe depression. Standardised effect size (ES) trials were pooled using random-effects modelling for which sufficient data were available. Economic data were summarised and acceptability data were synthesised via a textual narrative approach. Three trials targeted mothers/the children of mothers with psychotic symptoms. Children were ≤12 years of age and no primary QoL or emotional health outcomes were reported. Insufficient secondary outcome data prevented pooling and no eligible economic evaluations were found. Twenty-six trials targeted parents/children of parents with severe depression; 18 recruited mothers of infants<2.5 years of age. Data pooling suggested no significant short-term effect on children's emotional health [standardised ES 0.06, 95% confidence interval (CI) -0.20 to 0.33] or social function (standardised ES 0.23, 95% CI 0.00 to 0.46). Medium to large effects were observed for parents' depressive symptoms (standardised ES 0.73, 95% CI 0.51 to 0.94) and parenting behaviours (standardised ES 0.67, 95% CI 0.32 to 1.02). One non-randomised economic evaluation was found. Intervention uptake and adherence were inconsistently reported. Incomplete evidence highlighted potential barriers from child custody losses and conflicting life circumstances. Qualitative data suggesting interventions to overcome social isolation and stigma are well received by parents. Limited data suggested that children may value peer interactions and normalising activities. Included trials were of poor or unclear quality with inadequate randomisation or allocation concealment, possible attrition biases and incomplete outcome reporting. Meaningful analysis was challenged by clinical and methodological heterogeneity and insufficient data for subgroup comparisons. Children's self-reports were lacking and evidence of effect remains biased towards parent-based interventions for severely depressed mothers of infants. Generalisability to other diagnoses, older children and children of fathers with SMI is unclear. A lack of high-quality economic data prevented economic modelling. Evidence for community-based interventions to enhance QoL in children of SMI parents is lacking. The capacity to recommend evidence-based approaches is limited. Rigorous development work is needed to establish feasible and acceptable child- and family-based interventions, prior to evaluating clinical effectiveness and cost-effectiveness via a randomised controlled trial (RCT). A substantial programme of pilot work is recommended to underpin the development of feasible and acceptable interventions for this population. Evaluations should incorporate validated, child-centred QoL outcome measures, high-quality cost data and nested, in-depth acceptability studies. New age-appropriate instruments that better reflect the life priorities and unique challenges faced by children of parents with SMI may need to be developed. This report was commissioned by the NHS R&D Health Technology Assessment programme and funded by the National Institute for Health Research Health Technology Assessment programme.

Bullying behaviors in children and adolescents: "an ongoing story".

Bullying in school-aged children is a universal problem, which continues to be a serious threat to physical and emotional health of children and adolescents. This article highlights the prevalence, the common characteristics of bullies and victims, as well as the short- and long-term impact of bullying involvement. Key areas highlighted include the efficacy of bullying prevention programs, which can help health care providers to assess and provide interventions to children and adolescents affected by bullying.

Book Reviews

Please Don't Label My Child: Break the Doctor-Diagnosis-Drug Cycle and Discover Safe, Effective Choices for Your Child's Emotional Health. Scott Shannon and Emily Heckman. New York, NY: Rodale, 2007, 304 pp., $25.95 (hardcover).According to the title of Please Don't Label My Child by Shannon and Heckman (2007), the main themes of the book should have been about avoiding labels and things to do to prevent or counterbalance the effects of labeling. The book does an excellent job of describing what labeling is and how it can be both useful in some situations yet cause more harm than good because of the negative connotations, or stigmas, associated with labels. However, the book seemed to be more about the authors' concern about medicating children, and after the first chapter, the main focus of the book seems be how to properly raise children. There were no suggestions or alternatives to labeling; the best advice the authors gave on labeling was to avoid giving children labels, especially because the labels often represent a misdiagnosis. From a practical standpoint, it is often argued that giving labels is beneficial because children can then receive the help that they need in multiple sources, such as at school, home, or at the doctor.The real problem seems to lie in the stigmas that are associated with both diagnostic and disability labels, which is mentioned in the pros and cons discussion in the book. This position has been expressed by others. Green (2003) extends the negativity to the family members, stating that they also feel the backlash of labeling (a courtesy stigma). Green's article, "What do you mean 'what's wrong with her,'" captures the essence of how important it is to look at the individual as a person and not someone who is his or her diagnosis/ disability or even someone who has a diagnosis/disability.Modified labeling theory is a theory that Green (2003) and Kroska and Harkness (2008) cite as a source of negativity; it is when diagnoses and disabilities, both labels, become personally relevant and foster negative self-feelings. The second part of this theory is that cultural meanings, or stigmas, associated with these labels create expectations that trigger defensive behaviors aimed at avoiding rejection. Kroska and Harkness call these defensive behaviors a "secondary deviance" of the labels that further damage the social interactions, occupational successes, and self-image. It is the belief of Kroska and Harkness that stigmal sentiments can be operationalized through the evaluation (good vs. bad), the potency (powerful vs. weak), and the activity (active vs. inactive). In addition to these, there are reflected appraisals as part of the self-stigma sentiments.The best source of strength comes from within; the second comes from having a close support system. These are the issues addressed by Shannon and Heckman (2007); the latter is expressed also by Green (2003). Shannon and Heckman wrote that the keys to being emotionally healthy is to play into the child's inner strength by teaching the child to have a strong sense of self-identity, be able to self-regulate, and be resilient. …

Environmental risk factors and custody status in children of substance abusers

Children of substance abusers face myriad risks, including child maltreatment, residential instability, and exposure to violence, crime, and disorganization in their homes and neighborhoods. Using data from a substance abuse treatment program for women and their children, this study sought to examine the changes in children's living situations before and after their mother's treatment experience. First, we examined pre- and post-treatment changes in the legal and physical custody status of children, as well as neighborhood and household factors that can impact children's physical or emotional health and safety. Mothers who had at least one child living with them reported a significant decrease in problems in the home and neighborhood environments. Independent observations by research assistants also indicated few visible problems with the appropriateness of the post-treatment home and neighborhood environments for children. Second, we examined whether treatment completion predicted healthier living situations for children. Results indicated that treatment graduates were 2.5 times more likely to have at least one child living with them after treatment. In addition, non-graduates experienced more unwanted moves compared to graduates. These findings suggest that the homes and neighborhoods families return to post-treatment are, on the whole, relatively safe. • We studied mothers who entered residential substance abuse treatment. • We examined pre- to post-treatment changes in their children's living situation. • Improvements were seen in residential stability and home safety. • Outcomes were best for mothers who completed treatment and their children.

Promoting Adolescent health through an intervention aimed at improving the quality of their participation in Physical Activity (PAPA): Background to the project and main trial protocol

Funded by the European Commission, the Promoting Adolescent health through an intervention is aimed at improving the quality of their participation in Physical Activity (PAPA) project revolved around the potential of youth sport to promote children's mental and emotional health and physical activity engagement. A theoretically grounded coach education training programme (i.e. Empowering Coaching™), which was designed to create a sporting environment which was more positive and adaptive for young children, was customised for grassroots soccer, delivered and evaluated via a multi-method cluster RCT across five European countries; namely, England, France, Greece, Norway and Spain. In this article, a key part of the protocol of this large and multi-faceted project is presented. The ethical standards and procedures, characteristics of the population targeted and overall study design, and core self-report questionnaire measures completed by the players are described. Information is provided as well on the translation principles and procedures and data-collection procedures adopted in the PAPA project.

The Quality of Life in Care questionnaire: An assessment of feasibility, test–retest reliability and responsiveness in a clinical sample

This study determined the feasibility, test–retest reliability and responsiveness of the Quality of Life in Care (QOLIC), a measure of health-related quality of life (HRQoL) developed specifically for children in public care. Based on the Pediatric Quality of Life Inventory™ (PedsQL™) model, this questionnaire has previously demonstrated good validity and internal reliability. Two forms of the questionnaire are available, a self-completed report for children and a parallel proxy report for completion by carers. Thirty-five children aged between 8 and 17 years, and their carers, completed the PedsQL generic module and QOLIC on two separate occasions. At the second completion, carers and children were asked to rate whether the child's physical and emotional health had changed (improved, got worse or stayed the same) since the first questionnaire was completed to enable test–retest reliability and responsiveness to a change in health to be calculated. Both measures demonstrated good feasibility with missing responses of less than 1%. No floor effects and minimal to moderate ceiling effects were found. Test–retest reliability could not be established due to the small numbers reporting no change in their health status. However, it can be argued that responsiveness is more important, when looking at a changeable population such as this one. Good responsiveness was established for self-reported PedsQL and QOLIC measures, and for the proxy version of QOLIC. Therefore, this study provides further evidence that QOLIC provides a valid and reliable measure of HRQoL. QOLIC is easy to use and therefore has the potential to have a major impact on clinical practice with children in public care. It is recommended that future studies focus on assessing the ability of the measure to differentiate between groups of “looked-after” children.