Positive Outcomes For Children Research Articles

Cesarean Section Epidemic: Coping Strategies Adopted in Brazil

In this article, we discuss the strategic measures adopted in Brazil to reduce the high rates of cesarean sections. We present specific programs for both public health and supplementary health and for improving maternal and child health. We hope that these governmental initiatives, coupled with a paradigm shift in the Brazilian society regarding childbirth and women's health, will reduce cesarean section rates in the short and medium run, leading to positive outcomes for maternal and children's health and well-being.

The role of psychiatry in championing positive life outcomes for children and adults with neurodevelopmental disorders and their families.

Children and adults with neurodevelopmental disorders make up an estimated 10% of the population. Addressing health inequalities and poorer life outcomes is essential to deliver better quality care. Two parent-carers working in national roles in England suggest ways to increase understanding and work together in coproduction to achieve this.

Implementation evaluation of an early intensive behavioral intervention program across three agencies serving young children with Autism: A mixed methods study

IntroductionAutism evidence-based practices (EBPs), including early intensive behavioral interventions (EIBIs), are associated with improved and sustained positive outcomes for children with autism spectrum disorder (ASD). However, little is known about the quality of EIBIs delivered within community-based behavioral health systems, where many children with ASD receive services. These systems vary in their use and delivery of EBPs. Barriers and facilitators play a role in EIBI implementation within these settings. Therefore, this study sought to examine the naturally occurring implementation of the Early Learning Institute (ELI) program across three sites over a one-year period, in order to understand the implementation processes, identify barriers and facilitators to implementation, and explore staff perspectives of implementation outcomes. MethodsA multi-phase mixed methods (QUAN → QUAL) design was utilized to: (1) examine implementation outcomes of acceptability, appropriateness, and feasibility of the EIBI; (2) explore staff perspectives of implementation strategy use; and (3) identify areas of strength and growth to deliver EIBIs in community-based settings. Twenty-three participants at time-point 1 and 29 participants at time-2, including behavioral technicians and directors/supervisors (n = 4) from three implementation sites participated in the study. All participants completed the Acceptability of Intervention, Intervention Appropriateness, Feasibility of Intervention measures, and Organizational Readiness for Change Context Subscale, at two time-points. Informed by QUAN findings at time-point 1, semi-structured interviews were conducted with a sub-sample of participants (n = 13) who completed the surveys at time-point 1. Thematic analysis was completed with a comparison and consensus methodology. Quantitative and qualitative data were then integrated using a joint display to provide an in-depth assessment of implementation outcomes. ResultsQuantitative results indicated positive endorsements of implementation outcomes over time; notably, these results aligned with the qualitative data suggesting that the majority of staff shared positive attitudes about the implementation of this EIBI within their organizations. Qualitative results also highlighted key facilitators and barriers to implementation that fell within two major themes: inner contextual factors and innovation factors. ConclusionsFindings highlighted several determinants to the naturally occurring implementation of ELI across three settings. These findings may be generalized to inform the implementation processes of EIBIs in usual-care settings thereby facilitating uptake in organizations providing services to children with ASD.

Improving parenting knowledge through caregiver education in China.

Caregivers' parenting knowledge is of importance to child development and to achieve positive child outcomes. Even though some caregiver education programs have demonstrated positive effects, most of them are carried out in developed countries and among western samples. As a developing country with the second-largest child population worldwide, China has initiated caregiver education programs to promote parenting knowledge among caregivers since 2016. This study examines the effect of an innovative caregiver education program on caregivers' perceived increase of parenting knowledge. A total of 310 caregivers with a child aged between 0 and 3 from Z city, China, were randomly selected to complete a survey. Caregivers' perceived increase of parenting knowledge was assessed by five specified knowledge dimensions, namely, child growth, feeding behaviours, daily care, disease prevention and safety. The independent variable was program participation, measured by respondents' use of program services. OLS regression was employed to assess the association between caregivers' program participation and their perceived increase of knowledge, controlling basic demographic and socio-economic factors. In general, program participation had statistically significant associations with caregivers' perceived increase of parenting knowledge. The associations varied by service type. Particularly, online development evaluations and in-home sessions showed relatively consistent and positive effects on caregivers' perceived increase of parenting knowledge. This caregiver education program had a positive effect on caregivers' perceived increase of parenting knowledge, particularly through the use of the online development evaluations and in-home sessions. As one of the earliest initiatives of this kind in China, the findings reveal the promise of an innovative program to advance caregivers and children.

Women’s political empowerment and child health in the sustainable development era: A global empirical analysis (1990–2016)

ABSTRACT Empowering women is presented as a key strategy to achieve several goals of the sustainable development (SDG) agenda, including child health. However, the literature on the subject shows mixed results and is limited regarding political empowerment. Responding to this gap, we explore whether women’s political empowerment is associated with positive health outcomes for children under 5 years of age. We use the V-Dem project’s ‘Women’s Political Empowerment Index’ (WPEI) in combination with selected SDG indicators of child health from the Institute for Health Metrics and Evaluation’s 2017 Global Burden of Disease, for 161 countries, between 1990 and 2016. We estimate fixed-effects regressions for the WPEI against child mortality, stunting and immunisation coverage, controlling for structural and socio-economic indicators from the SDGs and potential lagged effects. The WPEI is associated with improved nutrition and immunisation but its substantive effect is small. High-, low-income and least developed countries benefit more from the effect of women’s political empowerment on child mortality. The effect of women’s political empowerment on stunting is stronger in middle-income countries while its effect on immunisation is more relevant to low-income and least developed countries. Our study demonstrates the complexity of the relations between women’s political empowerment and child health.

The ripple effect: Examining the impact on parents of an Abecedarian early child care intervention in an urban social housing development.

The Abecedarian Approach is an internationally recognised early childhood intervention program that has shown long-term positive outcomes for children living in low SES communities. However, there are few studies examining the broader influence of such interventions for young children on the lives of their parents. This article describes the findings of a qualitative study exploring the perceptions and experiences of parents whose children attend an Abecedarian early intervention program located in an urban social housing complex. Eighteen parents whose children had attended the program for a minimum of one year were interviewed. The main themes that emerged were: strengthened relationships between parents and program staff, as well as between parents themselves, particularly supported through the home visitor; increased awareness among parents about early development and of their role in supporting child development; and opportunities for parents’ personal growth. The findings suggest that high quality early child intervention programs, such as the Abecedarian Approach, can positively impact the lives of parents.

Improvements in Function Following Inpatient Activity-Based Therapy for Children With Acute Flaccid Myelitis.

Acute flaccid myelitis (AFM) is an illness defined by rapid onset of flaccid paralysis in one or more limbs or bulbar muscles, with MRI findings of predominantly spinal cord gray matter abnormalities spanning one or more spinal segments following a viral illness. Individuals with AFM may require rehabilitation to promote recovery. Activity-based restorative therapy (ABRT) has previously been shown to result in positive outcomes in children with neurologic deficits related to AFM. This study examined functional changes in a group of children with AFM who participated in ABRT in an inpatient setting. Retrospective chart review of children with AFM admitted to a single inpatient rehabilitation unit from 2014 to 2018. Children were assessed using the Functional Independence Measure for Children (WeeFIM), Manual Muscle Testing (MMT), Spinal Cord Independence Measure (SCIM), and the Physical Abilities and Mobility Scale (PAMS) as part of routine clinical care; the Modified Rankin Scale for Neurologic Disability was completed retrospectively. Children showed significant improvements across all outcome measures, with effect sizes ranging from moderate to large. Significant change was also seen across all muscle groups on MMT, with effect sizes ranging from small to large. Consistent with previous reports, children demonstrated better function in distal than proximal muscle groups at both admission and discharge. Children with AFM who participated in ABRT increased muscle strength and made functional gains across all outcome measures. These results support the utility of rehabilitation in the long-term care of children with AFM and residual neurologic deficit.

Supporting School Readiness Through Librarian-Child Interactions in Public Library Storytimes: An Analysis of Assessment Scores and Influential Factors

A recent trend in public libraries′ children’s services emphasizes the role of promoting school readiness. In order to gain a deeper understanding of the school readiness efforts present in storytime programs, this study observed and scored 68 public library preschool storytime sessions presented by 35 storytime providers across three states using the CLASS (Classroom Assessment Scoring System) measure. The CLASS evaluates adult-child interactions in learning environments within three domains related to positive outcomes in children’s school readiness: emotional support, classroom organization, and instructional support. Additionally, the study examined whether differences among CLASS scores were influenced by the population density of the library community, the storytime provider’s degree status and educational level, the provider’s prior teaching experience, the provider’s years of experience in children’s services, and the number of children participating in the storytime session. Results revealed that storytime providers score well in the CLASS’s emotional support and classroom organization dimensions but have room for improvement in the content-focused instructional support domain. Of the factors examined, only years of experience in children’s services was found to influence a provider’s CLASS score. These findings suggest that professional development programs should focus on preparing librarians to teach and model school readiness skills during storytime.

Parenting during the COVID-19 Pandemic.

Parenting is both an art and science of nurturing a child that comes very naturally to some. In today's world, the fundamentals of parenting are getting challenged but it has been even more magnified during the coronavirus 2019 (COVID-19) pandemic. The mental health of children is bound to be affected by the stress related to COVID-19 owing to loss of usual routine, unpredictability, uncertainty. Various other social, economic, and environmental factors also threaten their mental well-being. Parents are the child's first and longest-lasting context for development Positive parenting that involves sensitivity, responsivity, caring, communicating, and empowering would ensure positive developmental outcomes in children and adolescents. Positive parenting and self-care of parents would serve as a promotive and preventative intervention for child and adolescent mental health, especially during this crisis.

The role of the parent-child relationship in fostering resilience in American Indian/Alaskan Native children.

Resilience is a key characteristic to study in families, particularly those who have experienced significant systemic risk factors. While much resilience research focuses on ethnic and cultural minorities, little research focuses specifically on American Indian/Alaskan Native (AI/AN) families. The parent-child relationship has been demonstrated to be a key characteristic in families, and this relationship may also serve as a protective factor for AI/AN families. Positive parent-child relationships are consistently linked to positive child outcomes, and parental psychological symptoms are linked with child psychological symptoms in non-Native families. These associations warrant further examination among AI/AN families. We hypothesized that the parent-child relationship would moderate the link between parent distress (i.e., depressive and anxious symptoms) and child internalizing problems in a sample of 57 AI/AN parents of children 3-5 years of age. As expected, the parent-child relationship moderated the associations between parent anxiety symptoms and child internalizing symptoms, and between parent depressive symptoms and child internalizing symptoms. Furthermore, the strength of the parent-child relationship buffered the effects of parent distress on child internalizing symptoms. Results highlight the potentially protective role of strong parent-child relationships in AI/AN families.

Pediatric lung transplant: Correlation of pretransplant condition with post-transplant outcomes.

It is generally accepted that patients who have greater functional capacity are better candidates for lung transplantation. Accurate assessment of physical condition is important in identifying appropriate candidates for transplant. The focus of this study was to determine which measures of pretransplant physical condition correlate with positive post-transplant outcomes in children undergoing lung transplant. A retrospective chart review was done on 44 patients, ages 5 to 21years. The pretransplant data collected included functional status, 6MWT, ambulatory status, and mechanical support. Post-transplant outcome data included time on the ventilator, days in the ICU, length of hospitalization, and 12-month survival. Results were analyzed using Fisher exact and Kruskal-Wallis tests. Patients with limited ambulation had more days in the ICU compared to the most ambulatory group (P=.043). Patients independent or needing some help with ADL had less time on the ventilator compared to patients needing total help. (P=.014). Patients with 6MWT result greater than 500' had fewer ICU days (P=.044) and marginally better 12-month survival (P=.057). The 12-month survival of children needing invasive ventilatory support pretransplant was not significantly worse than those who did not; however, they required significantly more time on the ventilator (P=.004), days in ICU (P=.013), and longer hospitalization. This study demonstrated that pretransplant physical condition affects post-transplant outcomes in children. Measures associated with positive post-transplant outcomes were identified and could be beneficial in determining which patients are optimal candidates for lung transplant.

Development and validation of the theory-driven School Resilience Scale for Adults: Preliminary results

• School Resilience is a new theory-driven construct and psychometric instrument. • It is grounded on multisystemic and socio-ecological resilience theories. • School Resilience evaluates collective resilience within the school community. • It includes five protective or promotive factors that enhance wellbeing and resilience. • It is a tool for school prevention, evaluation, research and policy development. Resilience is the ability of an individual or community to adapt to life challenges or adversities while maintaining mental health and well-being. In the multi-systemic resilience paradigm, human development and resilience is embedded in adaptive systems and in their interactions. Although the relationship between school systems and adolescents' mental wellbeing is established, there is no agreement on how to recognize and evaluate the most relevant aspects of the school community, acting at collective level, to boost positive socio-emotional and educational outcomes in children and adolescents. This study presents the development and preliminary validation of a new and theory-driven construct and instrument, the School Resilience Scale for Adults (SRS). School Resilience comprises five interrelated constructs (i.e. Positive relationships, Belonging, Inclusion, Participation, and Mental health awareness) connected theoretically to wellbeing and resilience in children and adolescents. The scale development was theory-driven, and the instrument was tested in four European counties in the frame of the UPRIGHT project (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers). Overall, 340 adults participated, 129 teachers and school staff, and 211 relatives of teenagers. The sample was randomly split for two studies: (1) an Exploratory Factor analysis (ESEM), and (2) Confirmatory Factor (CFA) analysis. In the exploratory analysis, Chi-Square difference test and model fit indices point towards the five-factor solution over a three-factor solution. The confirmatory study indicated that a five-factor model (RMSEA = 0.038, CFI = 0.96, TLI = 0.95, SRMR = 0.045) was slightly better than a second-order model (RMSEA = 0.046, CFI = 0.94, TLI = 0.93, SRMR = 0.05). Convergent and discriminant validities were partially demonstrated. Alpha and omega reliability coefficients verified the measurement model of the scale. The results confirmed that a multidimensional construct of School Resilience, defined as a collective resilience factor, embedded in the school staff, family members, and adolescents’ interrelated systems can be characterized and measured. Further studies must determine its role in the promotion of adolescents' resilience, mental wellbeing, educational outcomes, and in their positive adaptation in challenging contexts.

Knowledge, Skills, and Self-reflection: Linking Trauma Training Content to Trauma-Informed Attitudes and Stress in Preschool Teachers and Staff

Increasingly, preschools are integrating trauma-informed interventions, which often include components of training, to improve practices and promote the well-being of children who have experienced trauma. Similar interventions have been linked to positive outcomes for older children; however, there is limited research that examines whether or how training on trauma specifically contributes to child and staff well-being within early childhood settings such as preschools. The current study examines the relationship between trauma-informed training content, trauma-informed attitudes, and stress in a sample of 111 preschool staff (49% lead teachers, 20% assistant teachers, and 27% other staff such as administrators and classroom aides). This study examined the unique influence of training related to trauma-informed skills (e.g., screening for trauma, responding to challenging trauma-related behaviors) and trauma-informed self-reflection (e.g., the impact of a child’s trauma on staff) on trauma-related attitudes and stress (including general stress and child-related stress) in a sample of teachers and staff with prior training on trauma-informed knowledge (e.g., definitions of trauma). Compared to those with only knowledge training, teachers and staff with self-reflection (β = .22, SE = .09, p = .014) and self + skills training (β = .50, SE = .13, p < .001) had stronger trauma-informed attitudes than those with only knowledge training. Direct pathways from training content and trauma-informed attitudes to general stress were not significant. Pathway from trauma-informed attitudes to child-related stress (β = − .51, SE = .12, p ≤ .001) and the indirect pathway from self-reflection training (β = − .11, p = .015) self + skill training (β = − .25, p < .001) to child-related stress through trauma-informed attitudes were significant. The findings of this study suggest that all trauma-informed training is not equal; training that focuses on self-reflection, such as the role of vicarious trauma, may be particularly important as part of a trauma-informed school approach. Trauma-informed attitudes are also an important mechanism through which trauma-informed interventions may influence staff well-being in preschool settings.

Strengthening family retention and relationships in home visiting programs through early screening and assessment practices

Evidence-based home visiting (EBHV) programs for pregnant women and families of young children prevent child maltreatment and improve maternal and child health outcomes. However, home visiting programs often struggle to retain families long enough to achieve positive outcomes. The current study (N = 1,032) sought to understand how home visitor relationship building skills and screening practices predict families’ duration in EBHV. Multilevel modeling revealed that screening practice helped retain families in EBHV programs longer. Interactions between screening practices and home visitors’ relationship building skills further showed screening practices were associated with longer duration in services when home visitor relationship building skills with families were weak. However, when home visitor relationship building skills were strong, screening practices were less influential on duration. Results suggest that screening practices may help build relationships with families which then enhances retention in services and increases the likelihood of achieving positive maternal and child outcomes.

Pathways to prevention: Early Head Start outcomes in the first three years lead to long-term reductions in child maltreatment

While there is growing evidence that early childhood prevention programs can have positive outcomes for children and families, research has tended to focus on short-term outcomes, with fewer studies of long-term benefits. In addition, evaluations of such programs rarely go beyond the question, “does the program work?” despite numerous calls over the past decade for more research that can help understand how these programs have their effects. Using longitudinal, experimental data from the Early Head Start (EHS) Research and Evaluation Project (EHSREP) linked to child welfare agency records for 2794 children, we examined the effectiveness of EHS birth-to-three services in preventing child maltreatment during children’s first 15 years of life. Following this, we assessed whether changes in specific child and family outcomes at ages 2 and 3 acted as mediators for later maltreatment prevention. Results showed that EHS has a long-term impact on the likelihood of child welfare system involvement that is driven by earlier impacts on parenting behaviors, family well-being, and child developmental status. By children’s second birthday, families randomly assigned to participate in EHS had lower family conflict and parenting distress, and more positive parent-child interactions; these impacts, in turn, led to later reductions in the likelihood of children being involved with the child welfare system through age fifteen years. Furthermore, at age three, children in EHS were more attentive and engaged in play with their parents and had higher scores on cognitive development assessments compared to controls; these outcomes were similarly associated with long-term reductions in the likelihood of child maltreatment. These findings suggest that early two-generational programs, like EHS, that are able to successfully decrease family conflict and stress and support positive, emotionally responsive parenting and child development, may reduce the likelihood of abuse and neglect later in life.

The Use of Nonspeech Oral Motor Exercises in the Treatment of Children With Cleft Palate: A Re-Examination of Available Evidence.

Purpose The purpose of this tutorial is to re-examine the current literature on nonspeech oral motor exercise (NSOME) in general and its use in the treatment of children with cleft palate specifically and provide a best practice recommendation. Method The Population Intervention Comparison Outcome process was used to investigate the clinical question. This systematic framework identifies the clinical population, evaluates the intervention(s) applied to the population, assesses the results of interventions, and delineates the outcome. A literature search, which examined developmental research, applied clinical research, and systematic treatment reviews, was conducted for this purpose. Results The literature reviewed herein suggests that, on a number of different levels, the implementation of NSOMEs does not result in positive communication outcomes for children with cleft palate who present with velopharyngeal dysfunction or compensatory speech errors. Conclusion Based on the current review, there is no empirical support for the use of NSOME as a direct or adjunct treatment for velopharyngeal dysfunction or compensatory speech errors. Appropriate treatments for these communication disorders include surgical, dental, and speech-based interventions.

Examining variation in the quality of instructional interaction across teacher-directed activities in head start classrooms

High-quality instructional interaction, in which teachers engage children in conversations that support the development of higher order thinking skills, conceptual understanding, and advanced language skills, is associated with positive outcomes for preschool children. Classrooms serving low-income preschoolers tend to have lower levels of this kind of instruction and yet research suggests that it may be particularly important for these children. The aim of this study was to examine variation in the quality of instructional interactions in Head Start classrooms across different types of teacher-directed activities. Twenty-four Head Start classrooms were observed across four activity types (circle time, math activities, science activities, and storybook reading), and quality of instructional interaction was assessed using the Instructional Support domain of the Classroom Assessment Scoring System. Science activities and storybook reading were associated with higher quality instructional interaction compared with circle time, controlling for teacher characteristics and classroom contextual factors. Math activities were not associated with higher quality instructional interaction compared with circle time. Science and storybook reading may be natural entry points for supporting higher quality instructional interaction in Head Start classrooms.

A Scoping Review of Relationship-based Training Programs for Early Childhood Educators.

Aim and Background: An increasing rise in childcare attendance has resulted in children spending additional time with non-parental caregivers, such as Early Childhood Educators (ECE’s). Strong relationships between children and ECE’s are important as these relationships impact on children’s development. Relationship-based training programs offered by occupational therapists, are one way of supporting educators with building and maintaining positive relationships with children in their care. This scoping review aimed to provide a summary of the features and outcomes of relationship-based training with ECE’s. Methods: After a systematic search and following PRISMA guidelines, a total of 26 studies were included. Results: A wide range of relationship-based training programs were described, with multiple components and group-based training, as well as individual consultation/coaching reported. All included studies reported that relationship-based training programs resulted in positive outcomes for children and/or educators. This review provides a foundation for designing relationship-based training programs for ECE’s.

Religious Motivation to Adopt as a Predictor of Adoptive Family Structure, Parental Discipline, and Outcomes

The purpose of this study was to examine religious motivation to adopt and how this relates to decisions families made while adopting, firm discipline, attachment, parent stress and affect, and child externalizing and internalizing. Within the United States, 44 internationally adopted children and their parents participated in this six-year, longitudinal study. Families endorsing greater religious motivation adopted older children and had larger family sizes. Controlling for these factors, greater religious motivation also predicted firmer discipline practices. Religious motivation did not predict parenting stress or parent negative affect. Additionally, positive longitudinal child outcomes were best predicted by larger family size, fewer baseline attachment disturbances, and less baseline externalizing and internalizing – rather than religious motivation, firm discipline, or the interaction between the two.

Leadership emergence and development: Organizations shaping leading in early childhood education

Early childhood education (ECE) effects positive outcomes for children, but outcomes depend upon the quality of the program with which children engage. Program quality is positively influenced by effective leadership; yet we do not fully understand how effective leadership emerges and develops within ECE sites. This lack of knowledge potentially compromises the development of effective leadership and, subsequently, a child’s right to high-quality ECE. This paper, therefore, contributes to the field of research on ECE leadership development by describing a qualitative Australian study that investigated leadership cultivation. The mini-ethnographic case study examined the emergence and development of leadership in three high-quality, diversely governed ECE settings. Findings of the study suggest the practice of leading is foundational for positional leadership roles and is enabled by the practice architectures of an organization. Practice architectures comprise cultural-discursive, material-economic and social-political arrangements. Arrangements, found within organizations, included cultures of trust, use of professional knowledge and language, collaborative development of philosophy, democratic allocation of resources, sharing of power and openness to activism, disruption and creativity. Such arrangements play an important role in the emergence and development of leading and therefore offer organizations alternative ways to consider leadership cultivation.