Services For Children Research Articles

Exploring changes in family functioning when a child participates in a School‐Based Filial Therapy program

AbstractChild focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child‐focused processes, which undermine rather than enhance child well‐being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child‐focused. Bowen theory is the guiding theoretical framework for School‐Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer‐regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed‐methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre‐ and post‐data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child‐focused processes remained dominant but changed in intensity and valence following SBFT.

Mental Health of Children and Adolescents before and during the COVID-19 Pandemic: How Did the Lockdown Modify Psychiatric Emergencies in Tuscany, Italy?

The COVID-19 pandemic has deeply impacted several aspects of the lives of children and adolescents. We analyzed the trends of psychiatric disorders in the emergency room. The analysis comprised the pre-pandemic (2018-2019) and the pandemic years (2020-2021). We conducted a retrospective observational epidemiological study that compared admissions during the two periods on a sample of 1311 patients aged between 4 and 18, focusing on new admissions vs. relapse, demographic variables, lockdown severity, presentation of psychiatric symptoms, diagnosis, severity, and outcome. Over the two-year pandemic period, we observed a 33% decrease in admissions to the emergency room for non-psychiatric disorders and a 200% increase in admissions for psychiatric emergencies. This increase is concentrated in periods with fewer restrictions and in the second year of the pandemic. We also observed a greater impact of psychiatric disorders on female patients, a greater severity of psychiatric disorders, a change in diagnoses associated with the presentation of symptoms, and an increase in hospitalizations. The children's psychiatric emergency service faced an "emergency within the emergency". In the future, it will be necessary to continue the follow-up of these patients, strengthen the field of study of gender psychiatry, and intensify our efforts towards prevention.

Adequacy of Children's Psychopharmacology Services: Variations by Race and Clinical Characteristics.

An expert consensus approach was used to determine the adequacy of children's psychopharmacology and to examine whether adequacy varied by demographic or clinical characteristics. Data were from the baseline interview of 601 children, ages 6-12 years, who had visited one of nine outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms study. Children and parents were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia and the Service Assessment for Children and Adolescents to assess the child's psychiatric symptoms and lifetime mental health services use, respectively. An expert consensus approach informed by published treatment guidelines was used to determine the adequacy of children's psychotropic medication treatment. Black children (compared with White children; OR=1.84, 95% CI=1.53-2.23) and those with anxiety disorders (vs. no anxiety disorder; OR=1.55, 95% CI=1.08-2.20) were more likely to receive inadequate pharmacotherapy; those whose caregivers had a bachelor's degree or more education (vs. those who had a high school education, general equivalency diploma, or less than high school education; OR=0.74, 95% CI=0.61-0.89) were less likely to receive inadequate pharmacotherapy. The consensus rater approach permitted use of published treatment efficacy data and patient characteristics (e.g., age, diagnoses, history of recent hospitalizations, and psychotherapy) to assess adequacy of pharmacotherapy. These results replicate findings of racial disparities reported in previous research using traditional methods to determine treatment adequacy (e.g., with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.

Educational experiences of young people with ADHD in the UK: Secondary analysis of qualitative data from the CATCh-uS mixed-methods study.

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and/or impulsivity. Young people with ADHD have poorer educational and social outcomes than their peers. We aimed to better understand educational experiences of young people with ADHD in the UK, and make actionable recommendations for schools. In this secondary analysis of qualitative data, we used Thematic Analysis to analyse information relating to experiences of education from 64 young people with ADHD and 28 parents who participated in the Children and adolescents with ADHD in Transition between Children's services and adult Services (CATCh-uS) study. Emerging patterns within and across codes led to organization of the data into themes and subthemes through an iterative process. Two main themes were generated. The first described young people's early experiences of education, often within a mainstream setting; we labelled this the problematic provision loop, as this was a negative cycle that was repeated several times for some participants. The second theme described young people's more positive progression through education once they progressed out of the problematic loop. Educational experiences for young people with ADHD are often negative and fraught with complication. Young people with ADHD often found themselves on a more positive trajectory after they were placed in an alternative form of education provision (mainstream or otherwise), or where they were able to study topics that interest them and play to their strengths. We make recommendations that commissioners, local authorities and schools could consider in order to better support those with ADHD.

Prevalence and Impact of Asthma and Allergy on Daily Life, Health Outcomes and Use of Healthcare Services in Children: A Population-Based Study

IntroductionStudies on the prevalence of asthma and allergies often lack representation of the pediatric population, and their impact has not been examined using children without these diseases as a reference group. This study aimed to determine the prevalence of asthma and allergies in children under 14 years old in Spain and their impact on health-related quality of life, activities, healthcare utilization, and environmental and household exposure risk factors. MethodsData came from a Spanish population-based representative survey of children aged <14 years (N=6297). A sample of controls (1:4) from the same survey was matched using propensity score matching. Logistic regression models and population-attributable fractions were calculated to determine the impact of asthma and allergy. ResultsThe population prevalence of asthma was 5.7% (95% CI: 5.0%, 6.4%), and of allergy was 11.4% (95% CI: 10.5%, 12.4. In children with lower percentiles of health-related quality of life (≤20th), 32.3% (95% CI, 13.6%, 47.0%) was attributed to asthma and 27.7% (95% CI: 13.0%, 40.0%) to allergy. Forty-four percent of restrictions in usual activity were attributed to asthma (OR: 2.0, p-value: <0.001), and 47.9% to allergy (OR: 2.1, p-value: <0.001). 62.3% of all hospital admissions were attributed to asthma (OR: 2.8, p-value: <0.001), and 36.8% (OR: 2.5, p-value: <0.001) of all specialist consults to allergy. ConclusionsThe high prevalence of atopic disease and its impact on daily life and healthcare utilization call for an integrated healthcare system focused on children and caregivers’ needs with continuity of care across education and healthcare settings.

Validation of the family focused mental health practice questionnaire in measuring health and social care professionals' family focused practice.

Parental mental illness is a major public health issue and there is growing evidence that family focused practice can improve outcomes for parents and their families. However, few reliable and valid instruments measure mental health and social care professionals' family focused practice. To explore the psychometric properties of the Family Focused Mental Health Practice Questionnaire in a population of health and social care professionals. Health and Social Care Professionals (n = 836) in Northern Ireland completed an adapted version of the Family Focused Mental Health Practice Questionnaire. Exploratory factor analysis was used to test the structure of the underlying dimensions in the questionnaire. The results, and theoretical considerations, guided construction of a model that could explain variation in respondents' items. This model was then validated using confirmatory factor analysis. Exploratory factor analysis revealed that solutions including 12 to 16 factors provided a good fit to the data and indicated underlying factors that could be meaningfully interpreted in line with existing literature. From these exploratory analyses, we derived a model that included 14 factors and tested this model with Confirmatory Factor Analysis. The results suggested 12 factors that summarized 46 items that were most optimal in reflecting family focused behaviours and professional and organizational factors. The 12 dimensions identified were meaningful and consistent with substantive theories: furthermore, their inter-correlations were consistent with known professional and organizational processes known to promote or hinder family focused practice. This psychometric evaluation reveals that the scale provides a meaningful measure of professionals' family focused practice within adult mental health and children's services, and the factors that hinder and enable practice in this area. The findings, therefore, support the use of this measure to benchmark and further develop family focused practice in both adult mental health and children's services.

Educational Services for Children with Autism Spectrum Disorder (ASD) in Autism Special School

The right educational services will help children with autism spectrum disorder (ASD) children to optimize their abilities. The purpose of this study was to analyze educational services for ASD children provided by a special ASD school in Bandung. This research uses qualitative methods in the form of case studies. Research instruments using interviews, observation, and documentation. The validity of the data is using the triangulation method. This study found that ASD special schools have provided optimal educational services according to the subjects' needs. The educational services provided follow the principles of teaching and learning, curriculum, approaches and methods, teaching and learning tools, and evaluation. Choosing the right educational service will help subjects optimally increase their potential. The implication of this research is program recommendations for teachers and parents in the continuation of the program that has been carried out to get optimal results for the subject.

The role of the voluntary, community and social enterprise sector in Early Help: Critical reflections from embedded social care research

AbstractThe independent review of children's social care (2022) has proposed a radical reset of England's children's services, shifting a remote, assessment heavy system towards one that works alongside communities to help prevent statutory interventions. However, notions around the harnessing of community resources to deliver Early Help are often underpinned by assumptions regarding the voluntary, community and social enterprise (VCSE) sector and the ease with which such organizations can be integrated into preventative strategies. This paper reports findings from embedded research within a unitary authority in Southwest England during remodelling of its Early Help service to work more collaboratively with local VCSE organizations. The study generated data from ethnographic observations, semi‐structured interviews and focus groups with 95 participants, including local parents, service providers, VCSE organizations and Council leaders. The findings illustrate that families value the compassionate, responsive and flexible support available within many VCSE settings. However, differences in practice cultures, regulatory pressures on statutory providers, the need to (re)build trust in communities and sensitivities around power‐sharing and resourcing meant negotiating VCSE sector integration was fraught with complexities. Few studies have gained such privileged access to a Local Authority's remodelling of Early Help services, and this paper has significant insights for the debates surrounding the independent review of children's social care (2022) and its recommendation to bring services ‘closer to communities’.

Education and Learning Services for Children with Learning Difficulties The Child With Special Needed

Various types of children with special needs, one of which is children with learning difficulties, namely individuals who experience disturbances in a basic psychological process, central nervous system dysfunction, or neurological disorders which are manifested in real failures in comprehension, impaired listening, speaking, reading, spelling, thinking, writing, arithmetic, or social skills. Learning difficulties can be experienced by anyone, from students with average intelligence to those with high intelligence. Learning difficulties can have a negative impact not only on the mastery of academic achievement but also on the development of one's personality. Neurological dysfunction often not only causes learning difficulties but can also lead to mental retardation and emotional disturbances. Of these, various causes can cause interference from a mild level to a severe level. A model is needed in the form of an early intervention program which is a combination of elements of kindergarten education and special education to encourage optimal and integrated growth and development of various potentials of children. This intervention program departs from the view that children are as a whole so that their development must cover all physical, emotional, language, social and cognitive aspects.

The Impact of a Multifaceted Simulation Education and Feedback Program for Community Emergency Departments on Pediatric Diabetic Ketoacidosis Management.

We sought to determine if general emergency departments (GEDs) were managing pediatric diabetic ketoacidosis (DKA) correctly and if management could be improved using a multilayered educational initiative. We hypothesized that a multifaceted program of in situ simulation education and formal feedback on actual patient management would improve community GED management of pediatric DKA. This study combined a prospective simulation-based performance evaluation and a retrospective chart review. A community outreach simulation education initiative was developed followed by a formal patient feedback process. Fifteen hospitals participated in simulation sessions and the feedback process. All hospitals were scored for readiness to provide care for critically ill pediatric patients using the Emergency Medical Services for Children (EMSC) Pediatric Readiness Assessment. Six of the 15 have had a second hospital visit that included a DKA scenario with an average performance score of 60.3%. A total of 158 pediatric patients with DKA were included in the chart review. The GEDs with higher patient volumes provided best practice DKA management more often (63%) than those with lower patient volumes (40%). Participating in a DKA simulated scenario showed a trend toward improved care, with 47.2% before participation and 68.2% after participation ( P = 0.091). Participating in the formal feedback process improved best practice management provided to 68.6%. Best practice management was further improved to 70.3% if the GED participated in both a DKA simulation and the feedback process ( P = 0.04). A multifaceted program of in situ simulation education and formal feedback on patient management can improve community GED management of pediatric patients with DKA.

Misalignment in Community Mental Health Leader and Therapist Ratings of Psychological Safety Climate Predicts Therapist Self-Efficacy with Evidence-Based Practices (EBPs).

Therapist self-efficacy in delivering evidence-based practices (EBPs) is associated with implementation outcomes, including adoption and sustainment in community mental health settings. Inner context organizational climate, including psychological safety, can proximally shape therapist learning experiences within EBP implementation. Psychologically safe environments are conducive to learning behaviors including taking risks, admitting mistakes, and seeking feedback. Organization leaders are instrumental in facilitating psychological safety, but may have differing perspectives of organizational climate than front-line therapists. Discrepant leader and therapist views of psychological safety may have independent associations with therapist EBP learning and implementation outcomes over and above average therapist perceptions of climate. This study examined survey data from 337 therapists and 123 leaders from 49 programs contracted to deliver multiple EBPs within a study examining determinants of sustainment within a large system-driven implementation. Both leaders and therapists completed measures of psychological safety climate and therapists reported on their self-efficacy in delivering multiple EBPs in children's mental health services. Polynomial regression and response surface analysis models were conducted to examine the associations of therapist and leader reports of psychological safety and therapist EBP self-efficacy. Greater discrepancies between leader and therapist reports of psychological safety, in either direction, were associated with lower therapist EBP self-efficacy. Alignment in leader and therapist views of psychological safety climate may impact EBP implementation outcomes. Strategies for improving alignment in perceptions and priorities among organizational members can be included in organizational implementation interventions and may represent unexamined implementation mechanisms of action.

RECRUITING STAFF FROM OVERSEAS

Amid ongoing shortages of social workers, children's services are increasingly turning to international recruitment to fill staffing gaps. Joe Lepper explores challenges and best practice

Abilities and Disabilities Among Children With Developmental Language Disorder.

The aim of this study was to situate developmental language disorder (DLD) within the impairment and disability framework of the International Classification of Functioning, Disability, and Health (ICF); describe the functional strengths and weaknesses of a cohort of first-grade children with DLD and their peers; and explore the ways that language-related disabilities relate to language impairment, developmental risk, and receipt of language services. We queried the caregivers of 35 children with DLD and 44 peers with typical language development about their children's language-related functions, developmental risks, and language services using mixed quantitative and qualitative methods. The children with DLD presented with weaknesses in domains that are highly dependent upon language skill, including communication, community function, interpersonal relationships, and academics. They presented with strengths in domestic and personal aspects of daily living, play and coping aspects of socialization, and gross motor function. Caregivers of children with DLD expressed pride in their children's agentive and prosocial qualities. Consistent with the ICF, what distinguished children with DLD who had functional weaknesses and disabilities from those who had healthy function was not the severity of language impairment as measured by decontextualized tests of language skill, but the presence of cumulative developmental risks. Compared to those with healthy function, a larger portion of children with weaknesses and disabilities were receiving language services; however, two girls who had disabilities despite mild levels of impairment were without services. Children with DLD present with predictable strengths and weaknesses in everyday language-related functioning. For some children, the weaknesses are mild, but for others, they limit function to a greater extent and should be considered disabilities. The severity of language impairment is not a strong indicator of language-related function and, therefore, is not a good metric for determining service qualification.

Nursery Services for Children Under 3 in Sichuan Province

To study the current status of nursery services for children under 3 in Sichuan Province, to analyze the problems and causes, and to provide policy recommendations for the high-quality development of nursery services in Sichuan Province for children under the age of 3. Using a combination of qualitative and quantitative methods, we analyzed the current status of nursery services in Sichuan Province and the problems encountered in the development of nursery services in Sichuan Province by collecting information on relevant government policies of Sichuan and the status quo of nursery services for children under 3 in the 21 cities/prefectures of Sichuan through policy research, interviews conducted at nursery service institutions, questionnaire surveys, and expert panel discussions. The supply of nursery services, or nursery enrollment capacity, in Sichuan Province reached 3 nursery enrollment opportunities per thousand people, with the enrollment utilization rate reaching 48.2%. Among all the nursery service institutions in the province, 55.4% were concentrated in the Chengdu, Mianyang, and Meishan regions. There were 1667 pilot nursery service institutions providing government-subsidized affordable nursery services and supplying 72971 subsidized affordable enrollment opportunities, accounting for 28.7% of the total number of all nursery service institutions and 29.1% of their total enrollment. There were a total of 37995 nursery service professionals, including 28468 caregivers (including teachers), with an average of 6 employees per institution and 5 caregivers per institution. 49.6% of the nursery service institutions hired healthcare workers on a part-time basis and 11.3% of them did not have healthcare workers on their staffs. Nursery services for children under 3 years old have developed rapidly in Sichuan Province, but there are a number of problems, including uneven distribution of resources in different regions, inadequate supply of government-subsidized affordable nursery services, mismatch between supply and demand, insufficient utilization of services, lack of professionals, and insufficient driving force for sustainable development in the industry. We have suggested that actions be taken to improve the policy and regulatory system for nursery services, actively develop care facilites that are government-subsidized affordable services, integrated daycare service for all preschool children, and integrated medical and education facilites, provide support for home care, establish an information system for nursery services, optimize the professional training and development system, strengthen scientific research and international exchanges on nursery services, and comprehensively promote the high-quality development of nursery services and the construction of a childrearing-friendly environment in Sichuan Province.

Bimbingan Motorik Anak Meleui Senam Sehat Di TK Al- Karimah Pekanbaru

Al-Karimah Kindergarten (TK) Is one of the kindergarten schools in the handsome sub-district of Pekanbaru City. The number of children participating in healthy exercise is 25 people, this is due to maintaining their health after the pandemic. the implementation of children's motor guidance service activities through healthy gymnastics at Al-Karimah Kindergarten Pekanbaru aims to improve children's motor skills through healthy gymnastics. This service is carried out through the Hero University research and community service center in collaboration with the principal of the Al-Karimah Kindergarten. The results obtained by this activity are through healthy gymnastic movements that can improve the motor skills of children in Al-Karimah Kindergarten. And can help teachers in solving problems that exist in kindergarten.

Legal Protection of Women and Children Victims of Sexual Violence in Gorontalo City Police

Legal protection in Indonesia is given to everyone based on equal rights and obligations as well as standing before the law. In this case, women and children are given extra legal protection because they are vulnerable to becoming victims of violence. In Gorontalo itself, the number of sexual violence increases every year. This is corroborated by the findings of cases of sexual violence from November 2019 to 2022, namely 105 cases. Regarding protection, the Gorontalo City Police Women's and Children's Service Unit has a role in protecting against all forms of violence, especially sexual violence. Sexual violence is defined as forced sex that can be performed by anyone who does not care about their relationship with the victim. The method used in this research is qualitative analysis, where research findings are obtained from literature research, document studies, and interviews. The purpose of this research is to find out legal protection efforts for women and children who are victims of sexual violence in Gorontalo and what are the inhibiting factors for legal protection for children and women who are victims of sexual violence themselves. In the findings of this study, legal protection for women and children who were victims of sexual violence, namely that victims immediately received assistance from the Integrated Service Center for Empowerment of women and children (P2TP2A) at the Gorontalo City Police in the initial process. Assistance is focused on the mental and psychological health of the victim. After that, if the victim is not satisfied with the process, the Integrated Women and Children Empowerment Service Center (P2TP2A) will assist the victim in submitting a report to the National Police so that it is followed up through the court process. The inhibiting factors found in this study were the victim's uncooperativeness in providing information due to mental disturbances due to trauma, as well as the location of the victim's house which was quite far away in terms of the process of providing legal protection itself.

Correction: The Evaluation of Health Care Services for Children and Adolescents With Post–COVID-19 Condition: Protocol for a Prospective Longitudinal Study

[This corrects the article DOI: 10.2196/41010.].

Examining Specialized Therapeutic Services for Children with Autism Spectrum Disorders

Examining Specialized Therapeutic Services for Children with Autism Spectrum Disorders

Assessment of Functioning of Health and Wellness Centers of Western Odisha: A Cross-Sectional Study.

Background The National Health Policy (NHP) 2017 of India recommends strengthening the delivery system of Primary Health Care through the establishment of Health & Wellness Centres (HWC) as the platform to deliver comprehensive primary health care services.HWCs are being set up as an upgraded version of existing sub-centers, primary health care centers, and urban primary health centers. This study was conducted to evaluate the functioning of health and wellness centers in Western Odisha. Objective To assess the availability of human resources, health care services, drug availability, lab services, and IT services at the health and wellness centers of Western Odisha. Methods Out of 10 districts of Western Odisha, two districts (Sambalpur and Deogarh) were selected for convenience, and a cross-sectional study was conducted from January 2021 to December 2022. All 43 health and wellness centers (35 rural primary health centers (PHCs) and eight urban PHCs) of the above two districts were included in the study. All relevant data were collected using a predesigned, pretested, and semi-structured questionnaire. Results The study showed that all 43 HWCs had good availability of pharmacists and lab technicians but less availability of medical officers, AYUSH medical officers, and staff nurses. Maternal and childhood services, family planning, and non-communicable disease (NCD) services were conducted regularly in all health and wellness centers, but basic oral health services and palliative care services were inadequate. All laboratory services like blood grouping, differential count/total leucocyte count, rapid test for pregnancy, urine albumin, urine routine examination/microscopic examination along with culture/sensitivity and water quality testing were done at urban PHC HWCs, whereas these lab services were less available at rural PHC HWCs.Drug groups like antipyretics, antihistaminic, antifungal, antihypertensive, oral hypoglycemic agent (OHA), antispasmodics, and antiseptic ointments were adequately available (>80%) at all urban and rural PHC HWCs. For IT support, appliances like desktops, internet facilities, and telephone facilitieswerefound to be present at all HWCs. Teleconsultation services were found to be available at 88% of urban PHC HWCs and 60% of rural PHC HWCs. ​Conclusion The study showed that infrastructure, human resources, and 12 service packages of health care and drugs should be addressed on a priority basis to achieve desired goals as envisaged by Ayushman Bharat to achieve the full potential of the health and wellness centers.

Implementation of children's right to work by involving them in artistic, sports and advertising events

In the article, a comprehensive study of the legal conditions and the procedure for involving children in artistic, sports or advertising events is carried out in accordance with the provisions of international legal standards, the legislation of Ukraine and the countries of the European Union, proposals are made to improve national legislation in order to effectively implement the labor rights of children.&#x0D; The topicality of the topic is due to the fact that the European integration processes continue in Ukraine. Therefore, a number of important changes have been implemented in the labor legislation over the past few years, which are aimed at establishing the freedom and safety of work. Nevertheless, the problem of protecting and protecting the labor rights of underage workers requires increased attention given the fact that in Ukraine there is practically no procedure for involving children in cultural, artistic and other similar activities, in sports competitions on the basis of an employment contract.&#x0D; The purpose of the conducted research was to contribute to the deepening of scientific views on the problem of ensuring the safety and health of children through the prism of the possibility of their work on the basis of an employment contract.&#x0D; On the basis of international legal standards and the legal regulation of child labor according to the legislation of the European Union, it is recommended to introduce a norm into the legislation of Ukraine, which provides for the possibility of involving the labor of children in artistic, sports and advertising events, under the age of 14, with the consent of the service for children's affairs in the event of an appeal by parents or legal representatives. The basis for issuing a temporary permit by the children's affairs service is proposed to be considered a petition letter from the employer specifying the working conditions and Conclusions on the state of health, physical and mental development of the child in a medical and preventive institution, which are submitted for consideration by parents or legal representatives. must be submitted by parents or legal guardians. The children's affairs service must carry out a comprehensive assessment of the relevant measure and check whether it can cause harm to the health, physical, mental, spiritual, moral and social development of the child. Before making a decision, the children's service must talk to the child.