Caregiver perceptions about mental health services after child sexual abuse

The objective of this study was to describe caregiver perceptions about mental health services (MHS) after child sexual abuse (CSA) and to explore factors that affected whether their children linked to services. We conducted semi-structured, in-person interviews with 22 non-offending caregivers of suspected CSA victims < 13 years old seen at a child advocacy center in Philadelphia. Purposive sampling was used to recruit caregivers who had (n = 12) and had not (n = 10) linked their children to MHS. Guided by the Health Belief Model framework, interviews assessed perceptions about: CSA severity, the child's susceptibility for adverse outcomes, the benefits of MHS, and the facilitators and barriers to MHS. Interviews were audio-recorded, transcribed, coded, and analyzed using modified grounded theory. Recruitment ended when thematic saturation was reached. Caregivers expressed strong reactions to CSA and multiple concerns about adverse child outcomes. Most caregivers reported that MHS were generally necessary for children after CSA. Caregivers who had not linked to MHS, however, believed MHS were not necessary for their children, most commonly because they were not exhibiting behavioral symptoms. Caregivers described multiple access barriers to MHS, but caregivers who had not linked reported that they could have overcome these barriers if they believed MHS were necessary for their children. Caregivers who had not linked to services also expressed concerns about MHS being re-traumatizing and stigmatizing. Interventions to increase MHS linkage should focus on improving communication with caregivers about the specific benefits of MHS for their children and proactively addressing caregiver concerns about MHS.     

Unresponsiveness in Children with Severe Disabilities: Potential Effects on Parent‐Child Interactions

This paper examines the potential effects on parent‐child interactions when children, because of severe mental and physical impairments, are unable to exhibit most social responses. A model is proposed to explain why a child is perceived to be responsive or unresponsive by parents and caregivers; the former applies only if the child's behaviour is recognized and valued by the observer. It is also proposed that: (a) perceived unresponsiveness may be more critical than the disability per se;(b) intense interactions early in the disabled child's development, commonly described by observers as controlling, intrusive behaviour, may be due to high levels of caregiver motivation and extinction burst effects; and (c) reductions in the amount of some caregiver‐child interactions may be the outcome of previously unrewarded interaction attempts and decreased expectancy levels.     

Sequential Associations Between Caregiver Talk and Child Play in Autism Spectrum Disorder and Typical Development

This study examined sequential associations between child play and caregiver talk in 98 caregiver–child dyads (M_{mental age} = 14 months). Fifty dyads included a child with autism spectrum disorder (ASD). Analyses revealed sequential associations between child play and caregiver follow‐in (FI) utterances (utterances related to the child's attentional focus) were stronger in the ASD as compared to the typically developing (TD) group. FI utterances were more likely to elicit functional play than caregiver‐focused utterances, and more so in the ASD group. Across groups, FI directives were more likely to elicit functional play than FI comments. These findings have important implications for research involving caregiver–child play as an early intervention context for children with ASD.     

Caregiver’s Mind-Mindedness in Early Center-based Childcare

Recent studies suggest that mind-mindedness is an important element of caregiver–child interactions in family and childcare context. This study investigated caregivers’ mind-mindedness in a nationally representative Dutch sample and its relation with structural quality factors (i.e., group size, caregivers’ education and work experience, group type, and situation) and caregivers’ interactive skills. Participants were 99 caregivers recruited in 50 childcare centers. Mind-mindedness was assessed with observations during free-play and lunch situations in infant, preschool, and mixed-age groups (0–4-year-olds). Caregivers’ appropriate and nonattuned mind-related comments were coded as individual (over/toward one child) or group related (over or toward more than one child). Caregivers’ interactive skills were assessed using the Caregiver Interaction Profile (CIP) scales. Research Findings: Caregivers generally refer to children’s desires, thoughts, and emotions in about 10% of their verbal interactions, with a low incidence rate of nonattuned comments (< 1%). Mind-mindedness was found to be significantly associated with structural quality characteristics and caregivers’ interactive skills. Caregivers with greater interactive skills produced fewer individual and more group appropriate mind-minded comments in mixed-age groups. Practice or Policy: We discuss the relevance of mind-minded comments at individual and group level for the future study of mental-state talk in early childhood education and care.     

The ABCs of family mealtimes: observational lessons for promoting healthy outcomes for children with persistent asthma

Family mealtimes have the potential to promote healthy child development. This observational study of 200 family mealtimes examined the relation between child health in a group of children (ages 5 to 12) with persistent asthma and 3 dimensions of mealtime interaction: Action, Behavior Control, and Communication. Percent time spent in Action and Positive Communication varied by asthma severity, child quality of life, and sociodemographic variables. Positive communication during mealtimes predicted child quality of life. Significant interactions between demographic variables and behavior control suggested that higher levels of behavior control affected child quality of life in the context of lower maternal education. Guidance is offered for practitioners and policy makers toward promoting healthy family mealtimes as a public health priority.     

Caregiver instability and early life changes among infants reported to the child welfare system

This study describes the extent of caregiver instability (defined as a new placement for 1 week or longer in a different household and/or with a new caregiver) in a nationally representative sample of infants, followed for 5–7 years. Data were drawn from the National Survey of Child and Adolescent Well-Being (NSCAW), a longitudinal study of 5,501 children investigated for child maltreatment. The analysis sample was restricted to 1,196 infants. Overall, 85.6% of children who were infants at the time of the index maltreatment experienced at least one caregiver instability event during their first 2 years of life. Caregiver instability was associated with the child having a chronic health condition and the caregiver being older than 40 years of age at baseline. The levels of instability reported in this study from infancy to school entry are extremely high. Children with more risk factors were significantly more likely to experience caregiver instability than children with fewer risk factors. The repeated loss of a young child's primary caregiver or unavailable, neglectful care can be experienced as traumatic. Some evidence-based programs that are designed to work with young maltreated children can make a substantial positive difference in the lives of vulnerable infants.     

Teaching Through Collaboration: Flexibility and Diversity in Caregiver–Child Interaction Across Cultures

Teaching supports the high-fidelity transmission of knowledge and skills. This study examined similarities and differences in caregiver teaching practices in the United States and Vanuatu (N = 125 caregiver and 3- to 8-year-old child pairs) during a collaborative problem-solving task. Caregivers used diverse verbal and nonverbal teaching practices and adjusted their behaviors in response to task difficulty and child age in both populations. U.S. caregivers used practices consistent with a direct active teaching style typical of formal education, including guiding children’s participation, frequent praise, and facilitation. In contrast, Ni-Vanuatu caregivers used practices associated with informal education and divided tasks with children based on difficulty. The implications of these findings for claims about the universality and diversity of caregiver teaching are discussed.     

Early Relationship Quality From Home to School: A Longitudinal Study

The aim of this investigation was to examine the role of social relationships in the home as predictors of social functioning in the first years of school. Longitudinal data gathered on 156 children from urban, low-income families were used to examine the unique contributions of mother-child attachment classification at ages 1 and 2 years, the child's relationship with another adult caregiver, the child's closeness to a sibling, and the child's status in the family relative to siblings between ages 3 and 4 years, to teacher reports of their own relationship to the child and the child's social skills in the classroom and peer relations. The role of family-based relationships as possible protective factors for children at social or demographic risk for problems in school was also tested. Results indicate that quality of different family relationships provides relatively independent and complementary information about early social functioning in school, with more limited evidence for compensatory or protective processes at work.     

Maternal abuse history and self-regulation difficulties in preadolescence

Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parent's own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mother's history of abuse in childhood relates to her offspring's self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the child's first 24–36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N = 488) who were identified as at-risk for child maltreatment was recruited at the time of their children's birth. Mothers and their children were assessed annually from the child's birth through 36 months, and at age 9–11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their children's self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her child's early life may have long-term developmental implications for child self-regulation.     

Caregiver perceptions of inclusive playgrounds targeting toddlers and preschoolers with disabilities: has recent international and national policy improved overall satisfaction?

The purpose of the current study was to survey and interview caregivers of children with disabilities (ages 2–5 years) to obtain their input as to whether current playground equipment meets their child's needs. A total of 149 participants agreed to participate. Caregivers (i) indicated that their child with a disability could not fully participate in the playground's offerings, (ii) felt that the playground was not appropriate for their child with a disability and (iii) dreamed of a fully inclusive playground that met their child's needs. The results also demonstrate that social participation barriers continue to remain for families who have children with disabilities despite the passing of international human rights standards targeting individuals with disabilities and a global focus in improving the overall well‐being of children with disabilities.     

Children with Behavioural and Emotional Difficulties: Complex Children,Complex Training for Teachers

This paper consists of two parents’ accounts of their experiences of having children with AD/HD. The article is divided into three distinct sections. In the first section the mother of ‘Simon’ describes her experience of bringing up a child who, from early infancy, presented challenging behaviour. She describes the effect of this on her family and her self esteem as a parent. She goes on to give an account of the process by which ‘Simon’ came to be diagnosed as having AD/HD and the effects of the ensuing treatment programme. In the second section the same writer describes the impact of her experience on her relationships with the extended family. The third section of the paper is provided by a second writer, who is also the mother of a child with AD/HD. This section focuses on the difficulties she experienced in dealing with her child's educational needs and the conflicts which arose between her and staff in her child's school.     

Mealtimes in Swedish preschools: pedagogical opportunities for toddlers learning a new language

This paper reports on a study which explores how routine activities in preschool can support young multilingual children’s participation, communication and development of languages. The paper takes as its starting point the idea that young children’s development takes place through interaction and participation, including in routine activities. Empirical data of mealtimes was gathered in eight toddler groups in a Swedish city, and analysed as a context for learning. The mealtimes were video recorded and interpreted by using an interaction analytic approach which allowed multiple layers of mealtime interactions, all of which impact on the level of participation available to children, to be explored. A detailed analysis of activities and opportunities for communication provides an additional perspective for understanding participation and language learning in institutional practices. The findings show how language learning is situated as a communicative and participatory experience, and that common and shared topics are crucial for participation. Further, a shift in children’s participation status during interaction at mealtime is possible. An extended way of incorporating language teaching into multilingual preschool contexts is discussed.     

Children's language and behavioural,social and emotional difficulties and prosocial behaviour during the toddler years and at school entry

The ability of young children to manage their emotions and behaviours is an important prerequisite for social adjustment and school readiness. With an increase in early‐onset behavioural difficulties in children, understanding changes in child behaviour during the preschool years and the factors that influence it is a priority for policy and practice. Despite much evidence on the association between language and behavioural difficulties in children, few studies have examined longitudinally language and problem/prosocial behaviour in early years. Using a UK community‐based sample, Dimitra Hartas, from the University of Warwick, examines the association between language, gender and behavioural, social and emotional difficulties and prosocial behaviour during the toddler years and at school entry. The findings showed a moderate decline in behavioural and social difficulties during preschool, and stability in emotional difficulties. Moderate associations were found between vocabulary and problem behaviour but not prosocial behaviour, with literacy‐based language emerging as a substantive predictor of teacher‐rated behaviour. These findings have important implications for early years provision.     

Determinants of child outcomes in a cohort of children in the Free Pre-School Year in Ireland, 2012/2013

The study analyses determinants of child outcomes in a cohort of children who participated in the Free Pre-School Year. Child outcomes are measured through a before-and-after assessment of children using the Early Development Instrument. The sample comprises 448 children in 70 early years centres. There are three main findings. First, children with more or better skills at the beginning of the study period tended to have more or better skills at the end of this period, and vice versa, indicating that the broad parameters of a child's progress during the Free Pre-School Year have already been set by the child's development during previous years. Second, child and family characteristics are the largest set of measured influences on child outcomes by comparison with the pre-school system, with social class being the single biggest influence. Third, there were significant skill gaps between children at the start of the Free Pre-School Year which remained unchanged or widened during the year. The main conclusion is that the measures required to improve child outcomes in pre-school need to extend well beyond the confines of the early years sector to include all influences, especially family and social class influences, on child development and need to begin at the start of the child's life.     

Challenges and Assistive Technology during Typical Routines: Perspectives of Caregivers of Children with Autism Spectrum Disorders and Other Disabilities

ABSTRACT

Children with Autism Spectrum Disorder (ASD) and other developmental disabilities can face challenges during typical daily routines. Assistive technology can be used to address the problems encountered during typical routines, yet the competence of caregivers of children with these disabilities in using assistive technology varies. This study was designed to explore Saudi Arabian caregivers’ perceptions about problematic typical daily routines. Caregivers of children with these disabilities were surveyed about the problems they encountered with typical routines, the solutions they found to the problems, the assistive technology they used in the solutions, and their training in and feelings of competence about using assistive technology. Caregivers experienced problems in playing, bathing, and mealtime routines and some found solutions using assistive technology. Over one-third of the caregivers did not feel at all competent in using assistive technology. Suggestions for future research as well as training and development for caregivers are provided.     

Small Talk: Identifying communication problems in maltreated children

Development of speech and language is rapid in early years, yet if developmental problems in speech and language are not addressed they are likely to continue and impact negatively on a child's overall development and their life trajectory. Children who have experienced abuse and or neglect are particularly vulnerable. The aim of this study was to develop a tool to assist in identifying a child's need for assessment by a speech pathologist so that there could be early identification of problems. A culturally sensitive tool was developed to be completed by the child's carer included questions on language, speech and hearing, voice, fluency, understanding sentences, vocabulary and expression. Sixty-five children aged between 4 and 8 years, who had experienced abuse and/or neglect participated in the study. Fourteen percent were Aboriginal. A speech pathologist undertook an assessment for each child and the results were compared with the information on the Small Talk tool. The Tool was found to be high in sensitivity but low in specificity, requiring further refinement. However, it has the potential to assist non speech pathologists to identify a child's need for speech and language assessment with the findings identifying the Tool as promising practice.     

Middle childhood,poverty, and adjustment: Does social support have an impact?

The present study evaluated 64 children and their primary caregivers who were living in poverty. The children were administered a stress measure, a social support measure, and a measure of self‐esteem. Caregivers completed a stress measure, a measure of child adjustment, and a demographic questionnaire. Social support was not found to moderate the relationship between stress and child outcome. However, social support was found to be one possible mediator of the child's reported stress on their self‐esteem. According to the mediating model, enhancing children's social support may positively influence their self‐esteem. Greater levels of self‐esteem can affect many aspects of children's lives, such as improving school performance and efforts toward achieving goals. Because of the important role that social support can play on children's self‐esteem, social support should be actively promoted through school and community groups and organizations, especially with children from disadvantaged economic situations. © 2001 John Wiley & Sons, Inc.     

Children's sleep regulation is linked to mothers’ sleep-related childhood experiences

The present research explored how mothers’ own childhood experiences are linked to their perceptions of their children's sleep regulation. It focused on collective sleeping; a practice used in the past in the Israeli kibbutz, and used a quasi-experimental research design to examine whether mothers who were raised in collective sleeping arrangements differed from mothers who were raised in home sleeping. Two typically developing cohorts: infants (n = 68; ages 9–15 months; M = 12.2, SD = 2.2) and preschool children (n = 113; ages 48–55 months; M = 51.5, SD = 1.85) participated in this investigation. Sleep regulation and temperament were reported for infants and children, whereas for mothers data were collected on separation anxiety and appraisal of the ecology in which they were raised. Collectively raised mothers evaluated their upbringing significantly more negatively than home-raised mothers, expressed higher separation anxiety with regard to an alternative caregiver, but were not different in their views of their child's sleep difficulties. For infants, it was maternal separation anxiety that contributed uniquely to the explained variance in maternal view of sleep regulation difficulties. For preschool children, it was maternal evaluation of own childhood ecology and child's temperament that contributed uniquely to the explained variance in maternal view of sleep regulation difficulties. These findings suggest that mothers’ representations of their sleep-related early experiences, rather than their childhood ecology in and of itself, influenced their perceptions about their child's sleep, which, in turn, affect child's sleep patterns. Implications to caregiving are discussed.     

Mapping the educational experiences of children with pathological demand avoidance

‘Pathological demand avoidance’ (PDA) describes a pattern of difficulties increasingly recognised as forming part of the autistic spectrum. Although clinical reports suggest that children with PDA are likely to experience considerable difficulties in education, their educational experiences have not yet been explored in any systematic way. In the current study, 42 parents of children with PDA completed a questionnaire about their child's educational experiences. Parents' responses indicated that this group of children displays high levels of problem behaviours in school, and receives corresponding high levels of special educational need support and professional involvement. Despite this support, the group had experienced high rates of exclusion and placement breakdown, with only 48% now in mainstream education. Parents reported relatively high satisfaction in their children's educational placements, with success defined by parents in terms of child outcomes, school characteristics and PDA‐specific factors. Findings are discussed with reference to what is known about the educational experiences of children with more typical autism spectrum conditions and in terms of the implications for the inclusion of this group of children with complex needs.     

Reactions to children's transgressions in at-risk caregivers: Does mitigating information,type of transgression,or caregiver directive matter?

This study examined whether caregivers who exhibit high risk for child physical abuse differ from low-risk caregivers in reactions to transgressing children. Caregivers read vignettes describing child transgressions. These vignettes varied in: (a) the type of transgression described (moral, conventional, personal), (b) presentation of transgression-mitigating information (present, absent), and (c) whether a directive to avoid the transgression was in the vignette (yes, no). After reading each vignette, caregivers provided ratings reflecting their: (a) perceptions of transgression wrongness, (b) internal attributions about the transgressing child, (c) perceptions of the transgressing child's hostile intent, (d) own expected negative post-transgression affect, and (e) perceived likelihood of responding to the transgression with discipline that displayed power assertion and/or induction. For moral transgressions (cruelty, dishonesty, hostility, or greed), mitigating information reduced caregiver expectations that they would feel negative affect and, subsequent to the transgression, use disciplinary strategies that display power assertion. These mitigating effects were smaller among at-risk caregivers than among low-risk caregivers. Moreover, when transgressions disobeyed a directive, among low-risk caregivers, mitigating information reduced the expectation that responses to transgressions would include inductive disciplinary strategies, but it did not do so among at-risk caregivers. In certain circumstances, compared to low-risk caregivers, at-risk caregivers expect to be relatively unaffected by transgression-mitigating information. These results suggest that interventions that increase an at-risk caregiver's ability to properly assess and integrate mitigating information may play a role in reducing the caregiver's risk of child physical abuse.