Body mass index and parent-reported self-estem in elementary school children: evidence for a causal relationship.

OBJECTIVE: To clarify relationships between body mass index (BMI) and self-esteem in young children at a population level. To assess whether low self-esteem precedes or follows development of overweight/obesity in children. DESIGN: Prospective cohort study in elementary schools throughout Victoria, Australia. Child BMI and self-esteem were measured in 1997 and 2000. SUBJECTS: Random sample of 1,157 children who were in the first 4 y of elementary school (aged 5-10 y) at baseline. MEASURES: BMI was calculated from measured height and weight, then transformed to z-scores. Children were classified as nonoverweight, overweight or obese based on international cut-points. Low child self-esteem was defined as a score below the 15th percentile on the self-esteem subscale of the parent-reported Child Health Questionnaire. RESULTS: Overweight/obese children had lower median self-esteem scores than nonoverweight children at both timepoints, especially at follow-up. After accounting for baseline self-esteem, higher baseline BMI z-score predicted poorer self-esteem at follow-up (P=0.008). After accounting for baseline BMI z-score, poorer baseline self-esteem did not predict higher BMI z-score at follow-up. While nonoverweight children with low baseline self-esteem were more likely to develop overweight/obesity (OR=2.1, 95% CI=1.2, 3.6), this accounted for only a small proportion of the incidence of overweight. CONCLUSIONS: Our data show an increasingly strong association between lower self-esteem and higher body mass across the elementary school years. Overweight/obesity precedes low self-esteem in many children, suggesting a causal relationship. This indicates that prevention and management strategies for childhood overweight/obesity need to begin early to minimise the impact on self-esteem.

The importance of first-time parent groups for new parents

First-time parent groups are offered to all new parents in Victoria, Australia through the Maternal and Child Health Service, which is funded by state and local governments. Parents who join a group attend a series of eight sessions that emphasize parenting skills, relationship development and social support in order to increase confidence and skills in parenting. The present paper highlights the importance of first-time parent groups, claiming that these groups serve an important social support and health function amid a climate of early discharge policies and changing family structures. Although there are a number of challenges to the successful running of groups, it is argued that first-time parents benefit from participating in these groups in a number of ways: by developing social networks, gaining self confidence, and through access to relevant information on child health and parenting. Research indicates that first-time parent groups provide lasting benefits not only for families, but also for society as a whole. Maternal and child health nurses play a key role in facilitating groups for first-time parents.

The relationship between child sexual abuse and academic achievement in a sample of adolescent psychiatric inpatients

Objectives:
To examine the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. Individual factors expected to influence this relationship were measured to explore the way they each interacted with sexual abuse and its relationship to academic achievement.

Method:
Eighty-one adolescent psychiatric inpatients participated in the study (aged 12–18 years: M = 16.0). Participants were administered tests of academic achievement (dependent variable) and intelligence, and completed a number of self-report measures of their experience of different types of maltreatment, their perception of the parenting they received, socio-economic status, substance abuse, and psychopathology.

Results:
Hierarchical regression analysis revealed that intelligence was the main predictor of academic achievement (uniquely explaining 26% of the variance). A number of interaction effects were also significant indicating that intelligence, substance abuse, internalizing behavior problems, externalizing behavior problems all influenced the relationship between sexual abuse and academic achievement.

Perceptions of local neighbourhood environments and their relationship to childhood overweight and obesity

OBJECTIVES: To examine associations between parent and child perceptions of the local neighbourhood and overweight/obesity among children aged 5–6 and 10–12 y. DESIGN: Cross-sectional survey. SUBJECTS: In total, 291 families of 5–6-y-old and 919 families of 10–12-y-old children. MEASURES: Parent's perceptions of local neighbourhood and perceived child access to eight local destinations within walking distance of home; 10–12-y-old children's perception of local neighbourhood; socio-demographic characteristics (survey). Children's height and weight (measured). RESULTS: No perceptions of the local neighbourhood were associated with weight status among 5–6-y-old children. Among 10–12-y-old children, those whose parents agreed that there was heavy traffic in their local streets were more likely to be overweight or obese (OR=1.4, 95% CI=1.0–1.8), and those whose parents agreed that road safety was a concern were more likely to be obese (OR=3.9, 95% CI=1.0–15.2), compared to those whose parents disagreed with these statements. CONCLUSIONS: This study suggests that parental perceptions of heavy traffic on local streets and concern about road safety may be indirect influences on overweight and obesity among 10–12-y-old children. Future work should also consider perceptions of the neighbourhood related to food choice.

Improving child and family outcomes following complicated births requiring admission to neonatal intensive care units

This paper reviews current research regarding the impact of birth complications, such as preterm labour, on parents and the nuclear family system. Specifically, how parents cope with the neonatal intensive care unit (NICU) experience and the associated decision-making tasks required during complicated births will be investigated. Consequences of poor adaptation to prematurity for the parent, family and infant relationships will also be discussed. The importance of informed decision-making, perceived control, self-esteem and the benefits of certain strategies, such as kangaroo care (skin-to-skin contact), in the facilitation of greater levels of attachment and improved relationships, will be highlighted. The paper concludes with suggestions for future research areas to focus on finding better ways to prepare and support parents in these situations, thus improving the quality of relationships between parents and with their child.

A preliminary investigation of the relationship between parental empathy and social anxiety and children's social anxiety

This study investigated the association between parents' social anxiety and empathy, and their children's social anxiety, Twenty-one mothers, 12 fathers and 24 children aged between 7 and 12 years were recruited from state primary schools in the eastern metropolitan region of Melbourne, Australia. Parents completed self-report questionnaires assessing their parental empathy and level of social anxiety. Children completed a modified version of the social anxiety questionnaire. All parent variables, except for maternal anxiety, were related to children's social anxiety. Overall, parental empathy was found to have a considerable association with child social anxiety, which is consistent with arguments that micro-level family mechanisms are important influences on child social anxiety. Future studies of parental empathy with clinical populations and data collection from multiple sources are recommended.

Healthy eating, activity and obesity prevention: a qualitive study of parent and child perceptions in Australia

Preventative health strategies incorporating the views of target participants have improved the likelihood of success. This qualitative study aimed to elicit child and parent views regarding social and environmental barriers to healthy eating, physical activity and child obesity prevention programmes, acceptable foci, and appropriate modes of delivery. To obtain views across a range of social circumstances three demographically diverse primary schools in Victoria, Australia were selected. Children in Grades 2 (aged 7–8 years) and 5 (aged 10–11 years) participated in focus groups of three to six children. Groups were semi-structured using photo-based activities to initiate discussion. Focus groups with established parent groups were also conducted. Comments were recorded, collated, and themes extracted using grounded theory. 119 children and 17 parents participated. Nine themes emerged: information and awareness, contradiction between knowledge and behaviour, lifestyle balance, local environment, barriers to a healthy lifestyle, contradictory messages, myths, roles of the school and family, and timing and content of prevention strategies for childhood obesity. In conclusion, awareness of food ‘healthiness’ was high however perceptions of the ‘healthiness’ of some sedentary activities that are otherwise of benefit (e.g. reading) were uncertain. The contradictions in messages children receive were reported to be a barrier to a healthy lifestyle. Parent recommendations regarding the timing and content of childhood obesity prevention strategies were consistent with quantitative research. Contradictions in the explicit and implicit messages children receive around diet and physical activity need to be prevented. Consistent promotion of healthy food and activity choices across settings is core to population prevention programmes for childhood obesity.

The relationship between childhood injuries and family type

This article focuses on the relationship between childhood injuries and family type. Injury is the leading cause of death among children in Australia. While children in sole-parent families were over-represented among the 17 percent of children who sustained an injury in the Growing Up in Australia study, once socio-economic indicators were taken into account, the increased risk for injury for children in a sole-parent family was no longer apparent. The Draft National Injury Prevention Plan was developed by the Australian Government Department of Health and Aging to aid in efforts for the prevention of child injury.

Pretend play and parents' view of social competence: the construct validity of the Child-Initiated Pretend Play Assessment.

Background and Aims: Play is the primary means through which children develop skills and socially interact with other children. The aim of this study was to investigate the relationship between pretend play and social competence in 4–5-year-old typically developing children, thereby adding further knowledge to the construct validity of the Child-Initiated Pretend Play Assessment (ChIPPA). Procedure: The pretend play ability of 35 preschool children aged 4–5 years was assessed using the ChIPPA. Parent/guardians of the children were interviewed regarding their child's social competence using the Vineland Social–Emotional Early Childhood Scales (Vineland SEEC Scales). Main Findings: No significant correlations were found between the children's play scores and their Vineland SEEC Scales scores. A significant and negative relationship was found between cooperation and sharing and elaborate play scores, suggesting that children who scored poorly on the play assessment were rated as cooperative by parents. Principal Conclusions: Parent report of social competence cannot be inferred from play scores. Reasons for the negative and significant finding are put forward and clinical implications of the findings are discussed. Additional investigations are necessary to further explore the construct validity of inferring social competence using the ChIPPA.

The relationship between childhood cruelty to animals and psychological adjustment : a Malaysian study

In Western research, cruelty to animals in childhood has been associated with comorbid conduct problems and with interpersonal violence in later life. However, there is little understanding of the etiology of cruelty to animals, and what in the child's life may require attention if the chain linking animal cruelty and later violence is to be broken. The study reported in this paper investigated the association between parent-reported cruelty to animals, and parent- and self-reported psychological strengths and weaknesses in a sample of 379 elementary school children in an Eastern context, Malaysia. No gender differences were found in relation to cruelty to animals or psychological problems, as assessed with the Strengths and Difficulties Questionnaire (SDQ). However, there were different predictors of cruelty to animals for boys and girls. Regression analyses found that for boys, parent-reported hyperactivity was a unique predictor of Malicious and Total Cruelty to animals. For girls, self-reported conduct problems was a unique predictor of Typical Cruelty to animals. Parent-reported total difficulties were associated with Typical, Malicious, and Total Cruelty to animals. We suggest that routine screening of children with an instrument such as the SDQ may help to detect those children who may need to undergo further assessment and perhaps intervention to break the chain linking childhood cruelty to animals and later conduct problems.

Discrepancy between expected and actual child support payments : predicting the health and health-related quality of life of children living in low-income, single-parent families

Objective Although the amount and frequency of child support payments received by single parents are often erratic and fluctuate, no study to date has quantitatively explored how the discrepancy between expected and actual payments relates to child health. This study aims to examine whether the discrepancy between expected and actual child support payments predicts a range of child health outcomes, including global health, health-related quality of life, involvement in activities and parental psychological distress.

Methods This study used results from the Longitudinal Study of Australian Children, which included a sample of parents of children aged 4–5 years (n = 4983). The questionnaire was completed by the parent who spent the most time with the child and knew the child best. From the 4983 families, 332 low-income single parents reliant on welfare with a formal or informal child support order in place were identified.

Results After controlling for income, the discrepancy between expected and actual child support predicted school functioning, conduct problems, total mental health problems and involvement in activities. Discrepancy between expected and actual child support payments did not predict the remaining health-related quality of life domains, mental health domains, global child health or parental psychosocial distress.

Conclusion This was the first study to examine how the discrepancy between expected and actual child support payments relates to child health, providing important data on the effectiveness of the child support system for children's well-being. These findings highlight the potential impact of the discrepancy on school functioning, conduct problems, total mental health problems and involvement in activities.

The influence of child support and welfare on single parent families

Many single parent families in Australia are on low-incomes and many depend on Centrelink Parenting Payments as their main source of income which is comparatively low to meet their basic living costs. The impact of low income on child health and social inclusion is discussed.

Utility of parent training for child behaviour difficulties

Focuses on parent training for child behaviour difficulties and includes four case studies providing a detailed assessment, formulation and evaluation of the treatment. The reports illustrate the utility of parent training alone and in combination with other psychological therapies and pharmacotherapy in the treatment of different childhood disorders.