Services For Children Research Articles

How Can We Better Serve Children with Disabilities? Public Library Accessibility Recommendations from Early Intervention Coordinators

ABSTRACT Service coordinators (SCs) play a vital role in assisting families in accessing and navigating the system of Early Intervention services that provide vital support to young children with disabilities and/or developmental delays (YCwD/DD). The study reports findings of focus group interviews with 14 SCs in three states in the United States that were subsequently coded and analyzed using a thematic analysis framework. SCs identified many ways that libraries support YCwD/DD through provisions of materials, services, spaces, and collaborative partnerships with community agencies. However, they pointed to additional measures libraries could take to better serve YCwD/DD and their families. Libraries might consider implementing changes to aspects of their policies and collaborative relationships in order to improve their responsiveness to the needs of YCwD/DD and their families.

Characteristics of Children with Cerebral Palsy and Their Utilization of Services in Saudi Arabia.

The recent emergence of research on cerebral palsy (CP) in developing countries aims to improve knowledge on affected children and the utilization of the available services. This study seeks to describe children with CP in Saudi Arabia and service utilization as per Gross Motor Function Classification System (GMFCS) levels and geographic regions. A cross-sectional survey of 227 children with CP (Mean age 6.3, SD 3.9 years) was conducted. Parents reported on children's demographics, impairments, and service utilization. Half of the children (n = 113, 49.8%) had ≥3 impairments with speech, visual and learning impairments being the most frequent. The total number of impairments differed significantly by GMFCS, F (4, 218) = 8.87, p < 0.001. Most of the children (n = 86, 83.4%) used 2-5 services. Moreover, 139 (62.3%) did not attend school, 147 (65.9%) did not receive occupational therapy, and only 32 (14.3%) received speech therapy. More children in GMFCS level I did not receive neurologist services. Profiles of children and services were described by GMFCS and by regions. This was the first study to describe children with CP and service utilization in Saudi Arabia. Although many impairments affected the children, there was low utilization of related services. Data on service utilization and on unmet needs support a comprehensive approach to rehabilitation and the proper service allocation.

Kriminalvården och Barnkonventionen

The Swedish Prison and Probation Service's and the UN Convention on the Rights of the Child Children belonging to incarcerated parents are typically a marginalised group within society who are often devoid of efficient support. This article discusses the realisation of children’s rights within the Swedish Prison and Probation Services based on the perspectives of staff members. This qualitative study has employed data collection through thematic interviews with staff at five institutions. In this article, the following four themes have been discussed: the difference in children’s rights based on a parent’s gender, the rights of a child to contact their incarcerated parent, the participation of a child within the Swedish Prison and Probation Services, and the staff's thoughts on the Prison Service's child rights perspective, current and future. The results display traditional norms continue to steer work within the Swedish Prison and Probation Services, partly creating differences in how children’s rights are realised, resulting in largely unseen parenting from fathers. There exist good examples of such realisations; however, a child’s perspective is largely influenced by staff commitment and individual interests. In implementing the CRC, respondents suggested an accompaniment of children placed in central units with their parents to provide the necessary support from educated staff. Furthermore, there is an additional desire for improved cooperation with social services.

Sociodemographic Disparities in Educational Services in Children who are Deaf or Hard of Hearing.

Examine the association between sociodemographic factors and Individualized Education Program (IEP) establishment. Retrospective cohort study. Tertiary referral center. Participants included deaf or hard-of-hearing children who were eligible for an IEP with "deafness" or "hard of hearing" as a primary or secondary disability. Primary outcome measures were time intervals between initial referral for services and parental consent; parental consent to determination of eligibility; and initial referral to eligibility (the sum of the previous 2 intervals). Student's t tests and linear regression were used to examine the association between sociodemographic factors and the primary outcome variables. Of the 88 participants, 51 (58%) were male, 45 (51%) were from underrepresented minority (URM) groups, 35 (40%) spoke a primary language other than English, and 53 (60%) utilized public insurance. IEP establishment was significantly delayed in participants who required an English-language interpreter. Most of the delay occurred in the time between the initial referral and parental consent (mean: 115 vs 37 days, P = .02). There were also significant delays from the time of referral for services to eligibility in URM participants (mean: 159 vs 85 days, P = .04). Significant delays were also associated with Minority Status and Language within social vulnerability index percentile rankings. This study found that IEP establishment was delayed in both URM participants and those who required an English-language interpreter. These results highlight the importance of clear communication between the school system and caregivers in the IEP establishment process, particularly with families who require an English-language interpreter or identify as URM.

Telehealth Use and Access to Neurology Outpatient Clinical Services for Children: An Observational Cohort Study.

Access to neurology services is important for children's well-being. We sought to evaluate the effects of telehealth on pedi-atric neurology appointment outcomes for children. Using electronic health record (EHR) data, information about children with pediatric neurology appointments in a tertiary care children's hospital in North Carolina was collected. Appointment outcomes (completion, cancellation, and no-show rates) were calculated for children who had a neurology appointment scheduled both in the pre-pandemic (March 10, 2019, to March 9, 2020) and pandemic (March 10, 2020, to March 9, 2021) periods. "Telehealth user" was a child who had at least one telehealth appointment scheduled between March 10, 2020, and March 9, 2021. In bivariate and multivariate analyses, we compared appointment outcomes for telehealth users and non-users. EHR data were limited to a single institution and could have missed children's clinical encounters elsewhere. Since this study used secondary data that were not collected for research purposes, it is possible that there were unmeasured confounders. Because of the observational nature of the study, the association between telehealth use and appointment outcomes does not indicate causation. A total of 2110 children had 11,194 pediatric neurology appointments scheduled. Telehealth users compared with non-users were more likely to be White, non-Hispanic, have private insurance, and live farther from the children's hospital. There was a statistically sig-nificant decrease in completion (66% versus 57%) and increase in cancellation (27% versus 33%) and no-show (7% versus 10%) rates in the pandemic when compared to the pre-pandemic period. In the pre-pandemic period, telehealth user and non-user groups had similar cancellation and no-show rates. In the pandemic period, there was a statistically significant decrease in cancellation and no-show rates in the telehealth user group when compared to the non-user group. Pediatric neurology outpatient clinic visits decreased substantially during the pandemic. Telehealth mitigated these problems. Children belonging to a minority race/ethnicity are less likely to use telehealth, increasing their risk of poor access to neurology services.

Impact of access to childhood health services on healthy life expectancy of the older population.

Life course theory provides new perspectives on the impact of early experiences on health in old age, where unfortunate childhood experiences can alter an individual's health trajectory. This study aims to calculate the healthy life expectancy of the older population in China under different childhood experiences, and to explore the influence of childhood medical and health services on the health level of older adults. Differences in healthy life expectancy of the older population under different childhood experiences were analyzed using the multi-state life table method to calculate the healthy life expectancy by sex and place of birth, based on the cohort data of Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. The probability of the transition risk from health to non-health gradually increased with age, while the probability of the transition risk from non-health to health decreased with age; In both urban and rural areas, on the probability of the transition risk from health to non-health, the older adults who were able to receive timely medical and health services in childhood were lower than those who failed to receive medical services in time (Z = -5.833, P < 0.05), but the probability of the transition risk from non-health to health was the opposite (Z = -5.334, P < 0.05); The probability of the transition risk from health to death is also higher in older adults who were unable to receive timely medical care in childhood (Z = -5.88, P < 0.05); The healthy life expectancy and its proportion in the remaining life expectancy of older people who received medical and health services in time during childhood were significantly higher than those of their peers (Z = -5.88, P < 0.05). The lack of medical services in childhood has a negative effect on the health of older adults. The healthy life expectancy and its proportion of remaining life expectancy were higher for rural older adults than for urban older adults under the same health care conditions in childhood; the health benefits of good access to health care environment or conditions in childhood were greater for rural older females.

Childhood contact with social services and self-harm and suicidal ideation in young adulthood: A population-wide cohort study in Northern Ireland

ObjectivesChildhood contact with social services is associated with adult suicide risk, but little is known about self-harm and suicidal ideation, which are recognised predictors of suicide. This study compares self-harm (SH) and suicidal ideation (SI) in young adults with childhood history of social services contact to unexposed peers.&#x0D; MethodA longitudinal, population-wide study of all children born 1985-1993 in Northern Ireland (NI) linking primary care registrations to social services data (1985-2015) and a national registry capturing all SH and SI presentations to the 12 Emergency Departments in NI (2012-2015). Multilevel logistic regression models estimated the association between level of contact with social services in childhood (no contact; referred but assessed as not in need (NIN); child in need (CIN); and child in care (CIC)) and SH, SI and any SH/SI, accounting for confounders and the amount of variation attributable to clustering by Health and Social Care Trust.&#x0D; ResultsThe cohort comprised 253,495 individuals (ages 18-30 years) alive and registered with a general practitioner during follow-up. Of the cohort, 4,026 presented with SH and 1,669 with SI. Individuals with a childhood history of social services contact comprised 10.8% of the cohort (2.9% NIN; 6.5% CIN; and 1.4% CIC) yet accounted for 40.9% of SH/SI cases. Likelihood of SH, SI, and any SH/SI increased stepwise with level of contact with social services. After full adjustment, young adults deemed NIN in childhood were three times more likely to present with SH/SI (OR 3.45 [95% CI 3.07-3.88]), former CIN five times more likely (OR 5.33 [95% CI 4.97-5.74]), and former CIC ten times more likely (OR 10.49 [95% CI 9.45-11.66]), relative to those with no contact.&#x0D; ConclusionAdults with a childhood history of social services contact, including those assessed as not in need, account for a disproportionate number of self-harm and suicidal ideation cases. Timely and targeted interventions aimed at this population have the potential to reduce the burden of self-harm and suicide

Children's workforce: Guide to Qualifications and Training

With many parts of the sector facing recruitment challenges, Joe Lepper identifies developments in entry-level requirements and ongoing professional development for children's services practitioners

Teachers' Perspectives on the Implementation of Inclusive Education Services for Children with Special Needs (ABK) in Indonesia: A Literature Review

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Teachers' Perspectives on the Implementation of Inclusive Education Services for Children with Special Needs (ABK) in Indonesia: A Literature Review.&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Perspective is a certain point of view, way of thinking, and attitude about something, the ability to understand or interpret a comprehensive phenomenon in a way that makes sense, in this study, namely the implementation of inclusive education services for children with special needs. This study aims to find out teachers' perspectives on the implementation of inclusive education services for children with disabilities in various parts of Indonesia. The research method used was a systematic literature review using articles obtained online from three databases, namely google scholar, science direct, and Garuda portal with a limit of publishing the last five years. Six articles met the criteria and the results of this systematic literature review showed that in general, teachers' perspectives are positive toward the implementation of inclusive education for children with disabilities, however, it has not been maximized because there are not many adequate human resources so it is necessary to increase the capacity of educators to improve the quality of inclusive education in Indonesia.&lt;/em&gt;&lt;/p&gt;&lt;strong&gt;&lt;em&gt;Keywords:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Teachers' Perspectives, Inclusive Education, Special Needs&lt;/em&gt;

Scaling Family Voices and Engagement to Measure and Improve Systems Performance and Whole Child Health: Progress and Lessons from the Child and Adolescent Health Measurement Initiative.

The 1997 legislation authorizing the United States Child Health Insurance Program sparked progress to measure and publicly report on children's healthcare services quality and system performance. To meet the moment, the national Child and Adolescent Health Measurement Initiative (CAHMI) public-private collaboration was launched to put families at the center of defining, measuring and using healthcare performance information to drive improved services quality and outcomes. Since 1996 the CAHMI followed an intentional path of collaborative action to (1) articulate shared goals for child health and advance a comprehensive, life-course and outcomes-based healthcare performance measurement and reporting framework; (2) collaborate with families, providers, payers and government agencies to specify, validate and support national, state and local use of dozens of framework aligned measures; (3) create novel public-facing digital data query, collection and reporting tools that liberate data findings for use by families, providers, advocates, policymakers, the media and researchers (Data Resource Center, Well Visit Planner); and (4) generate field building research and systems change agendas and frameworks (Prioritizing Possibilities, Engagement In Action) to catalyze prevention, flourishing and healing centered, trauma-informed, whole child and family engaged approaches, integrated systems and supportive financing and policies. Lessons call for a restored, sustainable family and community engaged measurement infrastructure, public activation campaigns, and undeterred federal, state and systems leadership that implement policies to incentivize, resource, measure and remove barriers to integrated systems of care that scale family engagement to equitably promote whole child, youth and family well-being. Population health requires effective family engagement.

Barriers to High-quality Therapy Services for Children with Autism Spectrum Disorder: An Analysis of Street-level Policy Practice of Therapy Service Organisations in China

Abstract Social workers with children with autism spectrum disorder (ASD) should assist them to have timely access to high-quality therapy services. This research addresses the gap between policy intention to improve the quality of therapy services and families’ unmet needs by examining the policy implementation practices of therapy service organisations. A longitudinal study was conducted in Beijing from 2013 to 2022. Qualitative data were obtained from policy documents and interviews with the managers of therapy service organisations (n = 17), therapists (n = 19) and families of children with ASD (n = 35). It found that the government policies created service challenges for the organisations. Managers adopted a short-term focus on organisational survival due to inadequate resources to implement the policy, intensified competition for therapists and service users and pressure from performance measurement. They focused on improving the sites, facilities, publicity and documentation of the organisations rather than the effectiveness of therapy services. Consequently, families still felt they were unable to access good quality therapy. The implications reinforce the significance for social workers to work with the government to actively supporting the training of therapists, establishing meaningful service quality measurement and promoting practical guidance about service quality standards to families of children with ASD.

Dental Care Services in Children: Pattern and Factors for Delay in Seeking Care among Tanzanian Paediatric Dental Patients

Seeking dental care services by responding to pain or potentially painful outcomes of advanced oral lesions impedes quality dental care for children. This study assessed patterns and factors associated to delay in seeking dental care among Tanzanian paediatric dental patients. It involved 312 child dental patient-escort pairs attending a university paediatric dental clinic in Tanzania. Structured questionnaires and clinical examination forms were used for collecting data. Frequency distributions, cross-tabulations and binary logistic regression were conducted to summarise the variables, test for the presence and magnitude of associations between delay in seeking care and socio-demographics plus dental services-related factors, respectively. Over two-thirds (68.6%) of the participants were delayed in seeking dental care; 45.2% were brought more than a month since the parents were informed or noted the child’s oral dental complaint. Delayed children were more likely to have had previous dental visits (OR =1.8 95% CI 1.1, 3.0) while less likely to require physically stabilised during the dental procedure (OR=0.5 95% CI 0.3, 1.0). In conclusion, the pattern and factors associated with delay in seeking care among Tanzanian paediatric dental patients were such that; most of the patients attended late, and dental-related factors explained the delay rather than the sociodemographic factors. Previous unsatisfactory dental experiences could explain the observation made. Ensuring quality of dental services provided, such as improving dental treatment outcomes and providing comprehensive dental care with enhanced preventive dental services

NHS at 75: The major challenges facing children's health services

To mark 75 years of the NHS, four sector experts assess how well the national institution is meeting the needs of children and what key improvements could be made to ensure health outcomes improve

Provider Perspectives on Telehealth Services for Children with Autism Spectrum Disorder During the COVID-19 Pandemic.

The purpose of the current study was to explore provider perspectives on the strengths and challenges of telehealth services (e.g., behavioral interventions, physical, speech, and occupational therapy, medication management) for children with ASD during COVID-19 related shutdowns. From September 2020 to May 2021, we conducted qualitative interviews with 35 providers across multiple disciplines from 17 sites in the Autism Care Network. Qualitative data was analyzed using a framework approach and common themes were identified. Providers across clinical disciplines identified strengths of the virtual model, such as its flexibility and the opportunity it provided to see children in their home environment. They also indicated that some interventions worked better virtually than others, and that there were several factors that impacted their success. Respondents were generally satisfied providing parent-mediated interventions but expressed mixed satisfaction in using telehealth for direct-to-patient care. Results suggest that telehealth services for children with ASD could be a helpful tool in decreasing barriers and improving service delivery, especially when tailored to the individual needs of the patient. More research is needed on the factors contributing to its success in order to eventually inform clinical guidelines regarding the prioritization of children seen for in-person visits.

Collaboration in Education Services for Children with Special Needs Inclusive School

Based on the observations and explanations of special guidance teachers in schools, inclusive education providers that the form of collaboration between teachers and stakeholders is still diverse. In general, this study aims to find out and obtain information about the implementation of collaboration between teachers and stakeholders in education services for children with special needs in schools providing inclusive education in Sukabumi. This research is a quantitative research. Data collection techniques are carried out by distributing questionnaires and recording initial data in the form of records that are understood by researchers without reducing the actual data. The results of the study can be concluded that collaboration in several aspects is still lacking such as teacher collaboration with SLB, teacher collaboration with related experts, lack of teacher collaboration with resource centers, teachers are also still lacking collaboration in carrying out learning activities. Meanwhile, there are several aspects that have begun to develop well, including teacher collaboration with parents, as well as teacher collaboration with special guidance teachers in inclusive schools, although not yet dehydrated, maximum results are expected to be a reference in building good collaboration between teachers and related stakeholders in creating effective learning in inclusive education. This study illustrates that inclusive education in its implementation process requires support from teachers and related stakeholders in order to run optimally.

Staff training in physical interventions: a literature review.

Restrictive practices are used frequently by frontline staff in a variety of care contexts, including psychiatric hospitals, children's services, and support services for older adults and individuals with intellectual and developmental disabilities. Physical restraint has been associated with emotional harm, physical injury to staff and consumers, and has even resulted in death of individuals in care environments. Various interventions have been implemented within care settings with the intention of reducing instances of restraint. One of the most common interventions is staff training that includes some physical intervention skills to support staff to manage crisis situations. Despite physical intervention training being used widely in care services, there is little evidence to support the effectiveness and application of physical interventions. This review will examine the literature regarding outcomes of staff training in physical interventions across care sectors. A systematic search was conducted following PRISMA guidelines using Cochrane Database, Medline EBSCO, Medline OVID, PsychINFO, and the Web of Science. Main search keywords were staff training, physical intervention, physical restraint. The MMAT was utilised to provide an analytical framework for the included studies. Seventeen articles have been included in this literature review. The included studies take place in a range of care settings and comprise a wide range of outcomes and designs. The training programmes examined vary widely in their duration, course content, teaching methods, and extent to which physical skills are taught. Studies were of relatively poor quality. Many descriptions of training programmes did not clearly operationalise the knowledge and skills taught to staff. As such, it is difficult to compare course content across the studies. Few papers described physical interventions in sufficient detail. This review demonstrates that, although staff training is a 'first response' to managing health and safety in care settings, there is very little evidence to suggest that staff training in physical intervention skills leads to meaningful outcomes.

An evidence-based demand management strategy using a hub and spoke training model reduces waiting time for children's therapy services: An implementation trial.

Waiting lists for community-based paediatric therapy services are common and lead to poorer health outcomes, anxiety and missed opportunities for treatment during crucial developmental stages. The Specific Timely Appointments for Triage (STAT) model has been shown to reduce waiting lists in a range of health settings. To determine whether providing training and support in the STAT model to champions within five community health centres using a remote 'hub and spoke' approach could reduce waiting time from referral to first appointment. Representatives from five community health centres providing paediatric therapy services (speech therapy, occupational therapy and other allied health services) participated in five online workshops over 6months. They were guided sequentially through the steps of the STAT model: understanding supply and demand, reducing backlogs, preserving space for new patients based on demand and redesigning models of care to maintain flow. Waiting time was measured in three consecutive years (pre, during and post intervention) and compared using the Kruskal-Wallis test. Employee satisfaction and perception of the model were explored using surveys. Data from 2564 children (mean age 3.2years, 66% male) showed a 33% reduction in waiting time from the pre-intervention (median 57 days) to the post-intervention period (median 38 days, p< 0.01). The total number of children waiting was observed to reduce from 335 immediately prior to the intervention (mean per centre 67, SD 25.1) to 112 (mean 22, SD 13.6) after implementation (t[8] =3.56, p< 0.01). There was no impact on employee satisfaction or other aspects of service delivery. Waiting lists are a major challenge across the health system. STAT provides a practical, low-cost, data-driven approach to tackling waiting times. This study demonstrates its effectiveness in paediatric therapy services and provides evidence for a 'hub and spoke' approach to facilitate implementation that could be provided at scale.

A response to decentralised governance of human rights: a Children's Rights Approach in Wales

ABSTRACT The dominant arrangement for governance in many States which are party to international human rights treaties is decentralisation. This puts implementation of human rights in the hands of institutions which are geographically closer to intended beneficiaries. Decentralisation to different levels of government introduces complexity, risk and opportunity to the governance of human rights. In response, UN Treaty Monitoring Bodies focus on State responsibility for implementation of human rights. The Committee on the Rights of the Child has emphasised the State as the coordinating body responsible for children's rights under the UN Convention on the Rights of the Child (CRC). In this paper, Wales is used as an example of a jurisdiction where decentralisation is a feature of children's rights, which has enabled a progressive approach to implementation. It explains the principled Children's Rights Approach which provides public authorities in Wales with a coherent framework to give effect to international children's rights policy planning and service delivery. As the contours of decentralisation in Wales are typical of arrangements in many States parties to the CRC, insights from Wales will be transferable to other jurisdictions. This experience is also relevant to other areas of human rights implementation in the context of decentralisation.

Creating the conditions for robust early language development for all: Part two: Evidence informed public health framework for child language in the early years.

One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well-documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years. To develop a proposal for the design and implementation of an early language public health framework based on current best evidence METHODS: We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years. An evidence informed early language public health framework is presented. Describing in turn (1) essential components; (2) relevant interventions; (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned); (4) system-level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention-intervention systems. Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described. What is already known on the subject Early child language development sets the stage for a child's life chances and language difficulties can have profound long-term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable. Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0-4 years. We detail the essential components, interventions and qualities of that framework and describe system-level structures and processes required to adopt and embed an early language public health framework in a given locality. WHAT ARE THE CLINICAL IMPLICATIONS OF THIS WORK?: A whole systems approach to early child language is required and should be co-designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement.

Reference and Information Sources and Services for Children and Young Adults

Reference and Information Sources and Services for Children and Young Adults