Caring for a child with autism: A practical guide for parents

book review

Raising a child with autism: A guide to applied behavior analysis for parents

book review

Why multiples matter: Reconceptualising the population referred to child and family social workers

Building on a body of previous research by the author and colleagues in relation to multiple adverse childhood experiences (MACE), this paper addresses the question of ‘why multiples matter’ in relation to issues of cumulative adversity. Illustrative evidence is drawn from three research domains, epidemiology, multiple services use and child maltreatment to demonstrate the collective weight of evidence to suggest a targeting of those children and families experiencing multiple adversities to diminish the effects of such adversities realised across the life-course. Whilst the history of previous largely unsuccessful attempts to widen the range of children prioritised for intervention by child and family social workers might lead to pessimism in relation to their ability to respond to a MACE informed public health agenda, there are clear possibilities for developing agency structures, assessment tools and social work practices directed toward meeting the needs of those sub populations already prioritised by social workers: namely Children in Need, Children in need of Protection and Looked after Children.

Working With Young Children as Co-Researchers: An Approach Informed by the United Nations Convention on the Rights of the Child

Research Findings: Under the United Nations Convention on the Rights of the Child (UNCRC), children have the right to express their views on all matters affecting them and to have those views given due weight. This right applies in the context of research; however, examples of young children being engaged as co-researchers remain rare. Practice or Policy: This article examines the implications of adopting an explicit UNCRC-informed approach to engaging children as co-researchers. It draws on a research project that sought to ascertain young children's views on after-school programs and that involved a university-based research team working along with 2 groups of co-researchers; each composed of 4 children aged 4 to 5. The article discusses the contribution made by children to the development of the research questions and choice of methods and their involvement in the interpretation of the data and dissemination of the findings. It suggests that, although there are limits to what young children can and will want to do in the context of adult-led research studies, an explicit UNCRC-informed approach requires the adoption of supportive strategies that can assist children to engage in a meaningful way, with consequent benefits for the research findings and outputs

Political Violence and Child Adjustment: Longitudinal Tests of Sectarian Antisocial Behavior, Family Conflict, and Insecurity as Explanatory Pathways

Understanding the impact of political violence on child maladjustment is a matter of international concern. Recent research has advanced a social ecological explanation for relations between political violence and child adjustment. However, conclusions are qualified by the lack of longitudinal tests. Toward examining pathways longitudinally, mothers and their adolescents (M = 12.33, SD = 1.78, at Time 1) from 2-parent families in Catholic and Protestant working class neighborhoods in Belfast, Northern Ireland, completed measures assessing multiple levels of a social ecological model. Utilizing autoregressive controls, a 3-wave longitudinal model test (T1, n = 299; T2, n = 248; T3, n = 197) supported a specific pathway linking sectarian community violence, family conflict, childrens insecurity about family relationships, and adjustment problems.

Cognitive-behavioural interventions for children who have been sexually abused

Background: Despite differences in how it is defined, there is a general consensus amongst clinicians and researchers that the sexual abuse of children and adolescents (’child sexual abuse’) is a substantial social problem worldwide. The effects of sexual abuse manifest in a wide range of symptoms, including fear, anxiety, post-traumatic stress disorder and various externalising and internalising behaviour problems, such as inappropriate sexual behaviours. Child sexual abuse is associated with increased risk of psychological problems in adulthood. Cognitive-behavioural approaches are used to help children and their non-offending or ’safe’ parent tomanage the sequelae of childhood sexual abuse. This review updates the first Cochrane review of cognitive-behavioural approaches interventions for children who have been sexually abused, which was first published in 2006.

Objectives: To assess the efficacy of cognitive-behavioural approaches (CBT) in addressing the immediate and longer-term sequelae of sexual abuse on children and young people up to 18 years of age.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2011 Issue 4); MEDLINE (1950 to November Week
3 2011); EMBASE (1980 to Week 47 2011); CINAHL (1937 to 2 December 2011); PsycINFO (1887 to November Week 5 2011); LILACS (1982 to 2 December 2011) and OpenGrey, previously OpenSIGLE (1980 to 2 December 2011). For this update we also searched ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP).

Selection criteria: We included randomised or quasi-randomised controlled trials of CBT used with children and adolescents up to age 18 years who had experienced being sexually abused, compared with treatment as usual, with or without placebo control.

Data collection and analysis: At least two review authors independently assessed the eligibility of titles and abstracts identified in the search. Two review authors independently extracted data from included studies and entered these into Review Manager 5 software. We synthesised and presented data in both written and graphical form (forest plots).

Main results: We included 10 trials, involving 847 participants. All studies examined CBT programmes provided to children or children and a nonoffending parent. Control groups included wait list controls (n = 1) or treatment as usual (n = 9). Treatment as usual was, for the most part, supportive, unstructured psychotherapy. Generally the reporting of studies was poor. Only four studies were judged ’low risk of bias’ with regards to sequence generation and only one study was judged ’low risk of bias’ in relation to allocation concealment. All studies were judged ’high risk of bias’ in relation to the blinding of outcome assessors or personnel; most studies did not report on these, or other issues of bias. Most studies reported results for study completers rather than for those recruited.

Depression, post-traumatic stress disorder (PTSD), anxiety and child behaviour problems were the primary outcomes. Data suggest that CBT may have a positive impact on the sequelae of child sexual abuse, but most results were not statistically significant. Strongest evidence for positive effects of CBT appears to be in reducing PTSD and anxiety symptoms, but even in these areas effects tend to be 'moderate’ at best. Meta-analysis of data from five studies suggested an average decrease of 1.9 points on the Child Depression Inventory immediately after intervention (95% confidence interval (CI) decrease of 4.0 to increase of 0.4; I2 = 53%; P value for heterogeneity = 0.08), representing a small to moderate effect size. Data from six studies yielded an average decrease of 0.44 standard deviations on a variety of child post-traumatic stress disorder scales (95% CI 0.16 to 0.73; I2 = 46%; P value for heterogeneity = 0.10). Combined data from five studies yielded an average decrease of 0.23 standard deviations on various child anxiety scales (95% CI 0.3 to 0.4; I2=0%; P value for heterogeneity = 0.84). No study reported adverse effects.

Authors’ conclusions: The conclusions of this updated review remain the same as those when it was first published. The review confirms the potential of CBT to address the adverse consequences of child sexual abuse, but highlights the limitations of the evidence base and the need for more carefully conducted and better reported trials.

Developing Evidence-Based Practice in Child Protection

This article argues for the adoption of an evidence-based approach to decision-making in child protection. Such a change hinges upon the availability of good quality, up-to-date evidence that is readily accessible to practitioners and policy-makers. Following a resume' of the arguments for recognizing controlled trials as methodologically superior to other forms of methodology in evaluating professional interventions, the article presents the case for adopting a similarly rigorous approach to synthesizing research findings. It then identifies a range of obstacles to promoting evidence-based practice and makes recommendations for changes in training, research, and practice which might facilitate improvement in both primary research and in reviews of the literature.

Children's rights and educational policy in Europe: the implementation of the United Nations Convention on the Rights of the Child

This article aims to shed light on the impact of the United Nations Convention on the Rights of the Child (CRC) on education policy in Europe. The findings are based on a documentary analysis of the published reports of the Committee on the Rights of the Child (the Committee) on the implementation of the education rights in the CRC in every EU state. This included: a review of the state of children's rights to education in Europe as perceived by the Committee; a summary of the Committee's key recommendations for governments; and an assessment of whether the CRC can be considered to have influenced domestic education law and policies. The findings suggest that the CRC is having an impact on domestic education policy and that the child rights framework could be harnessed further by those seeking to influence government. The article concludes by reflecting on the factors which affect the processes of translating the CRC into policy and practice and explores the role that educationalists, both academic and practitioners, might play in its implementation.