Destigmatizing Child and Adolescent Mental Health through Group Chat: A Workshop to Support the Emotional and Social Needs of Youth

The purpose of this project was to raise awareness surrounding child and adolescent mental health in an effort to reduce preconceived stigmas in relation to this specialized field. This project presented a literature review of the current state of child and adolescent mental health in Canada today, including the prevalence and several treatment options for young people confronting mental health challenges. Consideration of the powerful role of the education system upon youth with mental health issues became evident, specifically regarding early identification and prevention. A needs assessment was conducted to gather feedback from the clinical practitioners of a Section 23 classroom within a Southern Ontario hospital. This assessment was used to develop an informational and pedagogical workshop resource to extend practitioner understanding of this pertinent issue and support the social and emotional needs of young people confronting mental heath challenges. Results of the assessment indicated the significant need for such a workshop resource, and these responses were used to guide the development of Group Chat: A Workshop to Support the Emotional and Social Needs of Youth. The latter was subsequently presented to participants, whereby evaluative questionnaires indicated the efficacy and usefulness of this workshop resource to both practitioners and students alike.

Bone properties and skeletal maturity in adolescent males, as assessed by quantitative ultrasound

ABSTRACT Background: Previous studies have implied that weight-bearing, intense and prolonged physical activities optimize bone accretion during the grow^ing years. The majority of past inquiries have used dual-energy X-ray absorptiometry (DXA) to examine bone strength and hand-wrist radiography to determine skeletal maturity in children. Recently, quantitative ultrasound (QUS) technologies have been developed to examine bone properties and skeletal maturity in a safe, noninvasive and cost-effective manner. Objective: The purpose of this study was to compare bone properties and skeletal maturity in competitive male child and adolescent athletes with minimallyactive, age-matched controls, using QUS technology. >. Methods: In total, 224 males were included in the study. The 115 pre-pubertal boys aged 10-12 years consisted of control, minimally-active children (n=34), soccer players (n=26), gymnasts (n=25) and hockey players (n=30). In addition, the 109 late-pubertal boys aged 14-16 years consisted of control, minimally-active adolescents (n=31), soccer players (n=30), gymnasts (n=17) and hockey players (n=31). The athletic groups were elite level players that predominantly trained year-round. Physical activity, nutrition and sports participation were assessed with various questionnaires. Anthropometries, such as height, weight and relative body fat percentage (BF%) were assessed using standard measures. Skeletal strength and age were evaluated using bone QUS. Lastly, salivary testosterone (sT) concentration was measured using Radioimmunoassay (RIA). Results: Within each age group, there were no significant differences between the activity groups in age and pubertal stage. An age effect was apparent in all variables, as expected. A sport effect was noted in all physical characteristics: the child and adolescent gymnasts were shorter and lighter than other sports groups. Adiposity was greater in the controls and in the hockey players. All child subjects were pubertal stage (fanner) I or II, while adolescent subjects were pubertal stage IV or V. There were no differences in daily energy and mineral intakes between sports groups. In both age groups, gymnasts had a higher training volume than other athletic groups. Bone speed of sound (50s) was higher in adolescents compared with the children. Gymnasts had signifieantly higher radial 50S than controls, hockey and soccer players in both age cohorts. Hockey athletes also had higher radial 50S than controls and soccer players in the child and adolescent groups, respectiyely. Child gymnasts and soccer players had greater tibial 50S compared with the hockey players and control groups. Likewise, adolescent gymnasts and soccer players had higher tibial SoS compared with the control group. No interaction was apparent between age and type of activity in any of the bone measures. » Lastly, maturity as assessed by sT and secondary sex characteristics (Tanner stage) was not different between sports group within each age group. Despite the similarity in chronological age, androgen levels and sexual maturity, differences between activity groups were noted in skeletal maturity. In the younger group, hockey players had the highest bone age while the soccer players had the lowest bone age. In the adolescent group, gymnasts and hockey players were characterized by higher skeletal maturity compared with controls. An interaction between the age and sport type effects was apparent in skeletal maturity, reflecting the fact that among the children, the soccer players were significantly less mature than the rest of the groups, while in the adolescents, the controls were the least skeletally mature. Summary and Conclusions: In summary, radial and tibial SOS are enhanced by the unique loading pattern in each sport (i.e, upper and lower extremities in gymnastics, lower extremities in soccer), with no cumulative effect between childhood and adolescence. That is, the effect of sport participation on bone SOS was apparent already among the young athletes. Enhanced bone properties among athletes of specific sports suggest that participation in these sports can improve bone strength and potential bone health.

Perceived parental monitoring, adolescent disclosure, and adolescent depressive symptoms : a longitudinal examination

Parental monitoring has long been stressed as an important parenting practice in reducing adolescent susceptibility to depression. An extensive review by Stattin and Kerr (2000), however, , revealed that researchers had confounded perceptions of parental monitoring (i.e., parental solicitation and control) with parental knowledge, and neglected to consider the role of adolescent willingness to disclose. In the present study, adolescents (N = 1995; 51.3% female) were surveyed at two time points (grade 10 and 11). To disentangle the role of perceived parenting, three central issues were addressed. First, the present study examined whether parental knowledge, adolescent disclosure, and parental monitoring (i.e., parental solicitation and control) in grade 10 predicted adolescent depression in grade 11. Second, the predictive value of adolescent depression in grade lOon parental knowledge, adolescent disclosure, parental solicitation and parental control in grade 11 was considered. Lastly, associations among parental knowledge, adolescent disclosure, parental solicitation and parental control were examined over time. Findings indicated that higher levels of parental knowledge were associated with subsequent lower levels of depressive symptoms, and that depressive symptoms predicted lower levels of parental knowledge over time. Both adolescent willingness to disclose and parental control predicted higher parental knowledge. These findings underscore the role of adolescent and perceived parent contributions to parental knowledge, and highlight the importance of perceived parental knowledge in predicting reduced adolescent susceptibility to depression.

Moderating effects of gender and general self-efficacy on the relationship between sensation-seeking and adolescent substance use /

This study performed a aecondvy dau analysis of information collected during the Youth Leisure Study (YLS). The purpose of this study was to examine the potential moderating influences of gender and general self-efTicacy on the relationships aoKXig sensation-seeking and various forms of substance use in adolescents. Specifically, the predictive ability of sensation seeking on five adolescents substance use outcomes (alcohol, tobacco, and marijuana use; binge drinking; and number of times drunk) was examined. Moderated hierarchical multiple regression (MHMR) analyses were used to examine the relationships among study variables. The results for this study indicate that the relationships among sensation-seeking and forms of adolescent substance use are more complex than literature suggests. Main effect relationships were found consistently for sensation-seeking and general self-efficacy with each of the outcome variables. Results for gender were not consistent across the substance use outcomes. Gender was a significant predictor for marijuana use only. The moderating effects of general self-efficacy (GSE) on the sensation-seekingsubstance use relationship were inconsistent. While no significant interactions were found for tobacco or alcohol use outcomes, GSE was found to moderate the relationship between sensation-seeking and marijuana use indicating that feelings of high general selfefficacy act as a buffer or guard against marijuana use. A consistent pattern was found among the alcohol use variables (alcohol use. binge drinking, and number of times drunk). Gender was found to moderate each of these variables indicating that higher levels of sensation seeking are more predictive of higher levels of adolescent alcohol use in males only. Implications of this study on the field of education, are discussed further, and suggestions for future research are presented.

A tale of two childhoods : the virtual child and the real child in Romania, 1970s and 1980s

This thesis deals with the everyday use of propaganda in Romania, between 1971 and 1989. It explores the way in which the propaganda discourse of the Romanian Communist Party was disseminated through popular culture artifacts targeting children: Pioneers' magazines, textbooks, Almanacs and moralizing stories. These artifacts configured the image of a model child, whose preoccupations complied with the requirements of the Romanian Communist Party and communicated a set of recommended practices, to be followed by Romanian children. At the same time, the thesis incorporates the response of the actual children to these desirable practices, and implicitly, their response to state propaganda.

Postcolonial entanglements of Power, Race, Class and Privilege in Child and Youth Care Work Within a Brazilian Favela

This research assesses the various aspects of Child and Youth Care (CYC) work and how relationships between child or youth and care provider are limited and constricted within greater political, social and historical contexts. Specifically, this research takes place internationally in Rio de Janeiro, Brazil within a favela (slum) and unveils the entangled and complex relationship that I, not only as an ethnographer, but also as a CYC worker had with the many young people that I encountered. It will address a variety of theories that demonstrate the potentials of reproducing oppressive relationships, and argue that it is imperative for CYC workers to critically reflect on the greater contexts in which their work is situated in order to gain forces with those young people whom they are attempting to serve.

Correlates and outcomes of severe bullying: internalizing maladjustments of adolescent bullies, victims and bully- victims

The current study examined the association between involvement in bullying and victimization and internalizing difficulties such as self-esteem, social anxiety, depression and body image. Possible gender differences were also examined. The participants, high school students from Southern Ontario (N=533), were drawn from a larger, data set as part ofa study that was completed by the Youth Lifestyle Choices: Community Research Alliance (YLCCURA). The students completed a self-report questionnaire on a number ofmeasures; including, bullying, victimization, self-esteem, social anxiety, depression and body image. The results of this study suggest that those students who self-identified as victims and bully-victims also report higher levels of anxiety and depression than controls and bullies. Severe victims and bullyvictims had a lower body image than severe bullies and controls, whereas severe bullies seem to have a higher body image score than controls. These results are relevant when considering treatments and interventions for students experiencing adjustment difficulties who may also be at risk for bullying victimization. The results also suggest that particular attention needs to be focused on those adolescents who play multi-roles in bullying situations (i.e., bully-victims), since these students may come to the attention ofthe school system for externalizing behaviours, but may also need assistance for internalizing maladjustments.

Emergence of normative beliefs legitimizing antisocial behaviour in adolescents : the roles of monitoring, attachment, and temperament /

Beliefs about the rightness or wrongness of engaging in various antisocial acts, referred to here as nonnative beliefs legitimizing antisocial behaviour (nblab), have been shown to playa role in the emergence oflater antisocial behaviour. The current study represented an attempt to understand whether parental monitoring and parent-child attachment have differential relationships with these antisocial nonnative beliefs in adolescents of different temperaments. The participants, 7135 adolescents in 25 high schools (ages 10- 18 years, M = 15.7) completed a wide-ranging questionnaire as part of the broad Youth Lifestyle Choices - Community University Research Alliance project, whose goal is to identify and describe the major developmental pathways of risk behaviours and resilience in youth. Two aspects of monitoring (monitoring knowledge and surveillance/tracking), attachment security, and two measures of temperament (activity level and approach) were examined for main effects and in interactions as predictors of adolescent nonnative beliefs. All of these measures were based on adolescent self-ratings on either 3- or 4-point Likert-type scales. Several important results emerged from the study. Males were higher than females in nblab; parental monitoring knowledge and adolescent attachment security were negatively related to nblab; and temperamental activity level was positively related. Monitoring knowledge, the strongest of the predictors, was much more strongly related to nonnative beliefs than was parental surveillance/tracking, supporting the contention that it is how much parents actually know, and not their surveillance efforts, that predict adolescent nonnative beliefs. A surprising finding that is of the utmost importance was that, although several of the interactions tested were significant, none were considered to be of a meaningful magnitude (defined as sr^ > .01). The current study supported the suggestion that normative beliefs legitimizing antisocial behaviour are multiply determined, and the results were discussed with respect to the observed differential relations of parental monitoring, parent-child attachment, temperament, age, and gender to antisocial normative beliefs in adolescents. Also discussed were the need to test other parenting, temperament, and other variables that may be involved in the development of nblab; the need to directly test possible mechanisms explaining the links among the variables; and the usefulness of longitudinal research in determining possible directions of causality and developmental changes in the relationships.

A sequential analysis of therapist scaffolding and child concept formation in narrative therapy

Narrative therapy is a postmodern therapy that takes the position that people create self-narratives to make sense of their experiences. To date, narrative therapy has compiled virtually no quantitative and very little qualitative research, leaving gaps in almost all areas of process and outcome. White (2006a), one of the therapy's founders, has recently utilized Vygotsky's (1934/1987) theories of the zone of proximal development (ZPD) and concept formation to describe the process of change in narrative therapy with children. In collaboration with the child client, the narrative therapist formalizes therapeutic concepts and submits them to increasing levels of generalization to create a ZPD. This study sought to determine whether the child's development proceeds through the stages of concept formation over the course of a session, and whether therapists' utterances scaffold this movement. A sequential analysis was used due to its unique ability to measure dynamic processes in social interactions. Stages of concept formation and scaffolding were coded over time. A hierarchical log-linear analysis was performed on the sequential data to develop a model of therapist scaffolding and child concept development. This was intended to determine what patterns occur and whether the stated intent of narrative therapy matches its actual process. In accordance with narrative therapy theory, the log-linear analysis produced a final model with interactions between therapist and child utterances, and between both therapist and child utterances and time. Specifically, the child and youth participants in therapy tended to respond to therapist scaffolding at the corresponding level of concept formation. Both children and youth and therapists also tended to move away from earlier and toward later stages of White's scaffolding conversations map as the therapy session advanced. These findings provide support for White's contention that narrative therapists promote child development by scaffolding child concept formation in therapy.

A Foucaultian analysis of power relations in child protection case work with youth and families

This thesis takes some steps in examining the child protection system from a position that is rarely discussed. Specifically, I explore how Foucault's concept of disciplinary power can be used to demonstrate how power operates within the client/worker relationship. This relationship is shown to be quite complex with power flowing bidirectionally, rather than hierarchically. Instead of viewing power imbalances as a function of state control, I show how the client/worker relationship is constituted by the worker, the client, the organization and the social body. A postmodern auto ethnography is used to document my journey as I expose the disciplinary practices and instruments that I was subject to and used with my clients. 2 Given that the child protection system is constantly shifting and changing in order to improve its ability to safeguard children a greater emphasis is required to examine how workers operate within this complex, overwhelming and multi-dimensional world. This thesis has shown that by engaging in a reflexive examination of my position of power different approaches to making intervention beneficial to all involved become available. This is important if child protection work aims to work with clients rather than on clients.

Exploring the Family Context Among Children Adopted From China: Perceptions of Pre-Adoption Factors, Post-Adoption Experiences, and the Quality of Parent-Child Relationships

Within the context of international adoption, previous research has focused on parentchild attachment relationships and various aspects of the adoption process. However, less is known about other aspects of parent-child relationships (e.g., cohesion, conflict) within internationally adoptive families. Additionally, there is a need for research that explores both parent and child perceptions of the process of adoption - including pre- and post-adoptive factors - and its connection to the quality of parent-child relationships. This research utilized a qualitatively-oriented methodology to conduct separate, in-depth interviews with 10 adoptive Canadian mothers and their adopted Chinese children (aged 9 to 11 years). Results highlight parent and child reports of mainly strong, positive relationships. Several pre-adoption experiences are examined, including institutionalization, age at the time of adoption, and parental stress/expectations. A key finding concerns the link that adoptive parents perceive between the quality of their child's pre-adoptive care (i.e., mainly early institutionalized care) and the quality of their relationship. Interestingly, this link is perceived in two different ways - either as a challenge for the parent-child relationship or as a means to strengthen it. Post-adoption experiences are also explored, including cultural socialization, creating a transracial family, discussing adoption, parental stress, and sibling involvement. A key finding involves parent and child reports that cultural socialization efforts (i.e., familiarizing children with Chinese culture) are linked to more positive parent-child relationships. The implications of these findings are discussed in relation to theory and practice within the context of international adoption.

Parent and Peer Factors Relating to Adolescent Antisocial Behaviour: Investigating the Moderating Role of Temperament

The purpose of this study was to examine whether certain temperament characteristics (fearfulness, surgency, frustration, and effortful control) moderate the association between authoritative parenting dimensions (psychological autonomy granting, acceptance-involvement, and monitoring knowledge) or friends' antisocial behaviour, and self-reported antisocial behaviour among adolescents. Questionnaires on adolescent temperament and authoritative parenting were completed by 484 mothers and their adolescent children (54.8% female). In addition, the adolescents responded to measures regarding friends' antisocial behavior and their own antisocial behaviour. Adolescent participants ranged between 13 and 17 years of age (M = 14.96 years, SD = 1.39) and lived in a region of southern Ontario. As predicted, the results indicated that effortful control moderated the association between parental monitoring knowledge and adolescent antisocial behaviour. Also, as predicted, effortful control moderated the relation between friends' antisocial behaviour and adolescents' self-reports of antisocial behaviour although the relation was sex-specific to girls. Unexpected results included a significant monitoring knowledge by frustration by sex interaction, and a significant friends' antisocial behaviour by age interaction. In general, the findings were consistent with the expectation that the relation of parenting and peer factors to antisocial behaviour would depend on adolescents' temperamental predispositions. However, effortful control, which contributes to individual differences in self-regulation abilities, served this moderating role to a greater extent than the measures of temperamental reactivity, including fearfulness, surgency and frustration-proneness. Implications of these results are discussed with reference to parenting or classroom-based interventions that may be especially helpful for adolescents with poor self-regulation abilities.

Youth Living in Residential Care: Implications for Leisure and Identity

The purpose of this study was to explore the intersection of living in residential care, leisure engagement, and adolescent identity development. The investigation included the voices of six youth living in a residential care facility in southern Ontario. The data was collected through participant observations, semi-structured interviews, and document analysis. Moustakas’ (1994) modification of the Stevick-Colaizzi-Keen method was used to analyze the data. The findings determined that living in residential care is rife with dialectical tensions that impact leisure and identity. The youth shared poignant narratives of how living in residential care was a stigmatizing experience that left them feeling restricted and isolated. They also shared their struggles with finding autonomy in a secured facility and managing the violent discourses of their peers. This research contributes to a burgeoning body of literature that explores the experiences of youth living in out-of-home care. Implications for practice and future research are discussed.

Early detection and intervention for infants at risk of autism spectrum disorders

Autism is a developmental disorder that is characterized by abnonnal social interactions and communications as well as repetitive and restricted activities and interests. There is evidence of a genetic component, as 5% of younger siblings are diagnosed if their older sibling has been diagnosed. Autism is generally not diagnosed until age 3 at the earliest, yet it has been shown that early intervention for children with autism can greatly increase their functioning. Because of this, it is important that symptoms of autism are identified as early as possible so that diagnosis can occur as soon as possible to allow these children the earliest intervention. This thesis was divided into two parts. The first looked at the psychometrics of two proposed measures, the Parent Observation Checklist (POC), administered monthly, and the Infant Behavior Summary Evaluation (mSE), administered bimonthly, to see if they can be used with the infant population to identify autistic symptoms in infants who are at high risk for autism or related problems because they have an older sibling with autism. Study 1 reported acceptable psychometric properties of both the POC and IBSE in terms of test-retest reliability, internal consistency, construct validity and predictive validity. These results provide preliminary evidence that parent report measures can help to detect early symptoms of ASD in infants. The POC was shown to differentiate infants who were diagnosed from a matched group that was not diagnosed by 3 years of age. The second part of this thesis involved a telephone interview of parents who reported developmental and/or behavior problems in their high-risk infants that may be early signs of Autism Spectrum Disorder (ASD). During the interview, a service questionnaire was administered to see what interventions (including strategies recommended by the researchers) their at risk infants and affected older siblings were receiving, how satisfied the parents were with them and how effective they felt the interventions were. 3 Study 2 also yielded promising results. Parents utilized a variety of services for at risk infants and children with ASD. The interventions included empirically validated early intervention (e.g., ABA) to non-empirically validated treatments (e.g., diet therapy). The large number of nonempirically validated treatments parents used was surprising, yet parents reported being involved and satisfied, and thought that the services were effective. Parents' perceptions of their stress levels went down slightly and feelings of competence rose when they accessed services for their infants. Overall, the results of this thesis provide new evidence that parent-report methods hold promise as early detection instruments for ASD in at-risk infants. More research is needed to further validate these instruments as well as to understand the variables related to the parents' choice of early intervention for their at risk and affected children.