Effectiveness of child protection training for pre-service early childhood educators

International evidence confirms that early childhood educators can enter professional practice unprepared for child protection due to inadequate pre-service preparation. This paper makes an original contribution by using the Child Protection Questionnaire for Educators (CPQE) to examine the pre- and post- intervention child maltreatment and protection knowledge of early childhood and primary teaching students. While students’ knowledge increases significantly after participating in a child protection training programme, Pastoral Pathways, as part of their undergraduate study, post-intervention scores vary between groups. The study provides evidence of programme effectiveness and future training needs of pre-service educators. Findings are relevant to teacher educators and child care training providers in relation to programme content development and evidencing knowledge and skills acquisition.

Understanding Parental Influence on Educational Outcomes Among 9 Year Olds in Ireland: The Mediating Role of Resources, Attitudes and Children's Own Perspectives

The relationship between parental background and children's educational outcomes has been a dominant theme within the sociology of education. There has been an on-going debate as to the relative merits of explanations which focus on the role of socio-cultural reproduction and those which focus on rational choice. However, many empirical studies within the social stratification tradition fail to allow for children's own agency in shaping the relationship between social background and schooling outcomes. This paper draws on the first wave of a large-scale longitudinal study of over 8,000 nine-year-old children in Ireland, which combines information from parents, school principals, teachers and children themselves. Both social class and parental education are found to have significant effects on reading and mathematics test scores among nine year olds. These effects are partly mediated by home-based educational resources and activities, parents' educational expectations for their child, and parents' formal involvement in the school. More importantly, children's own engagement with, and attitudes to, school significantly influence their academic performance. The influence of children's own attitudes and actions can thus reinforce or mitigate the effect of social background factors. The analysis therefore provides a bridge between the large body of research on the intergenerational transmission of inequality and the emerging research and policy literature on children's rights.

Adherence to antiepileptic medicines in children: A multiple-methods assessment involving dried blood spot sampling

Purpose: To evaluate adherence to prescribed antiepileptic drugs (AEDs) in children with epilepsy using a combination of adherence-assessment methods.
Methods: A total of 100 children with epilepsy (=17 years old) were recruited. Medication adherence was determined via parental and child self-reporting (=9 years old), medication refill data from general practitioner (GP) prescribing records, and via AED concentrations in dried blood spot (DBS) samples obtained from children at the clinic and via self- or parental-led sampling in children's own homes. The latter were assessed using population pharmacokinetic modeling. Patients were deemed nonadherent if any of these measures were indicative of nonadherence with the prescribed treatment. In addition, beliefs about medicines, parental confidence in seizure management, and the presence of depressed mood in parents were evaluated to examine their association with nonadherence in the participating children.
Key Findings: The overall rate of nonadherence in children with epilepsy was 33%. Logistic regression analysis indicated that children with generalized epilepsy (vs. focal epilepsy) were more likely (odds ratio [OR] 4.7, 95% confidence interval [CI] 1.37-15.81) to be classified as nonadherent as were children whose parents have depressed mood (OR 3.6, 95% CI 1.16-11.41).
Significance: This is the first study to apply the novel methodology of determining adherence via AED concentrations in clinic and home DBS samples. The present findings show that the latter, with further development, could be a useful approach to adherence assessment when combined with other measures including parent and child self-reporting. Seizure type and parental depressed mood were strongly predictive of nonadherence. © 2013 International League Against Epilepsy.
Key Words: Adherence, Epilepsy, Dried blood spots, MARS, Depressed mood.

In Two Minds? Parental Attitudes toward Physical Punishment in the UK

Since the Millennium, the use of physical punishment in the home has been a widely debated topic across the UK. Reliance on public opinion has been an important feature of this debate with a variety of UK surveys showing that many find physical punishment acceptable and do not support a complete ban on smacking. Drawing on the results from a comprehensive review of the literature, this article highlights that public/parental opinion is less than straightforward. Parents are often ambivalent about physical discipline, do not view it as an optimal method of behaviour management and are more prone to smack when stressed or angry. Likewise, a survey of the disciplinary practices and attitudes of 1000 parents in Northern Ireland shows that majority of parents have negative attitudes towards physical discipline. Nonetheless, many parents continue to smack despite the fact they do not believe it to be effective. Lack of parental support for legislative reform should be reconsidered in the light of this ambivalence. Most important, the UK Government needs to reframe the smacking debate in terms of children's rights rather than relying on public opinion if it is to fulfil its commitment to protect children from harm as set out in the United Nations Convention on the Rights of the Child.

Incorporation of the United Nations Convention on the Rights of the Child in Law: A Comparative Review

Incorporation in law is recognised as key to the implementation of the UNCRC. This article considers the ways in which a variety of countries have chosen to incorporate the CRC, drawing on a study conducted by the authors for UNICEF-UK. It categorises the different approaches adopted into examples of direct incorporation (where the CRC forms part of domestic law) and indirect incorporation (where there are legal obligations which encourage its incorporation); and full incorporation (where the CRC has been wholly incorporated in law) and partial incorporation (where elements of the CRC have been incorporated). Drawing on evidence and interviews conducted during field visits in six of the countries studied, it concludes that children’s rights are better protected – at least in law if not also in practice – in countries that have given legal status to the CRC in a systematic way and have followed this up by establishing the necessary systems to support, monitor and enforce the implementation of CRC rights.

A cluster randomised controlled trial of “Bookstart+”: a book gifting programme

Purpose – The purpose of this paper is to evaluate the effectiveness of a free book gifting programme, called “Bookstart+”, in improving family reading outcomes.

Design/methodology/approach – Bookstart+ consists of a pack of books and reading materials provided to families at their two-year-old child's statutory health visit. The pack is accompanied by a short priming demonstration, delivered by the health visitor, on shared reading. The evaluation took the form of a randomised controlled trial (RCT) with 460 families from the client lists of 115 health visitors.

Findings – The study found evidence of: a positive significant effect on parents’ attitudes to reading and books (Cohen's d=+0.192, p=0.034); no significant effect on parental attitudes to their child reading (d=+0.085, p=0.279); and a negative effect, approaching significance, on public library usage (d=-0.160, p=0.055).

Research limitations/implications – The attrition rate was high, with only 43.9 per cent of the target families completing all of the research. However, this level of attrition did not lead to any significant differences between the control and intervention groups on their pre-test measures.

Practical implications – The study provides recommendations for free book gifting service provision in relation to pack contents and delivery.

Originality/value – This paper contributes to the limited international RCT evidence on free book gifting programmes.

A pilot study of a family focused, psychosocial intervention with war-exposed youth at risk of attack and abduction in north-eastern Democratic Republic of Congo

Rural communities in the Haut-Uele Province of northern Democratic Republic of Congo live in constant danger of attack and/or abduction by units of the Lord's Resistance Army operating in the region. This pilot study sought to develop and evaluate a community-participative psychosocial intervention involving life skills and relaxation training and Mobile Cinema screenings with this war-affected population living under current threat. 159 war-affected children and young people (aged 7-18) from the villages of Kiliwa and Li-May in north-eastern DR Congo took part in this study. In total, 22% of participants had been abduction previously while 73% had a family member abducted. Symptoms of post-traumatic stress reactions, internalising problems, conduct problems and pro-social behaviour were assessed by blinded interviewers at pre- and post-intervention and at 3-month follow-up. Participants were randomised (with an accompanying caregiver) to 8 sessions of a group-based, community-participative, psychosocial intervention (n=79) carried out by supervised local, lay facilitators or a wait-list control group (n=80). Average seminar attendance rates were high: 88% for participants and 84% for caregivers. Drop-out was low: 97% of participants were assessed at post-intervention and 88% at 3 month follow-up. At post-test, participants reported significantly fewer symptoms of post-traumatic stress reactions compared to controls (Cohen's d=0.40). At 3 month follow up, large improvements in internalising symptoms and moderate improvements in pro-social scores were reported, with caregivers noting a moderate to large decline in conduct problems among the young people. Trial Registration clinicalTrials.gov, Identifier: NCT01542398.

The influence of parents, older siblings, and non-parental care on infant development at nine months of age

Background: The majority of research examining the influence of social environment on early child development suggests benefits to two-parent households, but contradictory evidence for the effects of siblings. The aims of the present study were to examine the influence of the child's proximal social environment, and the effects of interactions between socioeconomic status and social environment on developmental outcomes.

Methods: Primary caregivers of a representative sample of 10,748 nine-month-old infants in Ireland completed the Ages and Stages Questionnaire and provided information on social environment. Adjustment was made for infant and maternal characteristics, household income, and area where the child was living at the time of the study. Further analyses tested for interactions between social environment and household income.

Results: Binary logistic regressions indicated no effects for number of parents in the household. However, the presence of siblings in the household was a consistent predictor of failing to reach milestones in communication, gross motor, problem-solving, and personal-social development. Furthermore, there was a gradient of increasing likelihood of failing in gross motor, problem-solving, and personal-social development with increasing numbers of siblings. Care by a grandparent decreased the likelihood of failing in communication and personal-social development.

Conclusions:These findings do not support the majority of research that finds positive benefits for two-parent households. Similarly, the findings suggest limited effects for non-parental care. However, the observed negative effects of siblings support both the confluence and resource dilution models of sibling effect. Examination of follow-up data may elucidate current findings.

Adherence to treatment in children and adolescents with cystic fibrosis: a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

BACKGROUND: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence.

METHODS: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale.

RESULTS: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence.

CONCLUSIONS: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children.

Applying the recovery approach to the interface between mental health and child protection services

There are a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and inquiry reports, as complex and problematic. This paper proposes that more positive, integrated approaches to service user engagement, risk assessment and management may lead to better outcomes in working with families experiencing parental mental health problems and child protection concerns. It is proposed that the recovery approach, increasingly used in mental health services, can inform the processes of engagement, assessment and intervention at the mental health and child protection interface. The article provides a critical overview of the recovery approach and compares it with approaches typifying interventions in child protection work to date. Relevant research and inquiries are also examined as a context for how to more effectively respond to cases where there are issues around parental mental health problems and child protection. The article concludes with case material to illustrate the potential application of the recovery approach to the interface between mental health and child protection services.

Did the Millennium Development Goals Change Trends in Child Mortality?

There has been little assessment of the role the MDGs have had in progressing international development. There has been a 41 per cent reduction in the under-5 mortality rate worldwide from 1990 to 2011 and an acceleration in the rate of reduction since 2000. This paper explores why this has occurred and results for all developing countries indicate that it is not due to more healthcare or public health interventions but is driven by a coincidental burst of economic growth. Although the MDGs are considered to have played an important part in securing progress against poverty, hunger and disease there is very little evidence to back this viewpoint up. A thorough analysis of the successes and failures of the MDGs is therefore necessary before embarking on a new round of global goals.