The impact of caring for a child with cerebral palsy : quality of life for mothers and fathers

Background:  Although it is expected that caring for a child with cerebral palsy (CP) can impact on the quality of life (QOL) of caregivers, the QOL of carers' has yet to be adequately examined. The aims of this study are to: (1) explore the QOL of mothers and fathers of children with CP aged 3–18 years; and (2) examine whether the impact of caring for a child with CP changes from childhood to adolescence.

Method: A qualitative study was conducted utilizing a grounded theory framework. Twenty-four mothers and 13 fathers of children and adolescents with CP aged 3–7 years (n = 15), 8–12 years (n = 10) and 13–18 years (n = 12) and with varying levels of impairment (GMFCS Level I = 1, II = 4, II = 3, IV = 5, V = 12) participated in semi-structured interviews about their QOL. The transcripts were analysed to identify issues affecting parental QOL.

Results: There were no differences in parental QOL among subgroups (i.e. mothers and fathers, age groups, GMFCS levels). Parental QOL ranged across a wide spectrum. Caring for a child with CP affects a parent's physical well-being, social well-being, freedom and independence, family well-being and financial stability. Parents indicated that they often feel unsupported by the services they access.

Conclusions: Caring for a child with CP can both positively and negatively impact on a parent's life. There is value for both parents and children if parental concerns and determinants of QOL are considered in overall programme planning and service delivery for children and their families.

Assessing the validity of impact pathways for child labour and well-being in social life cycle assessment

Background, aim and scope: Assuming that the goal of social life cycle assessment (SLCA) is to assess damage and benefits on its ‘area of protection’ (AoP) as accurately as possible, it follows that the impact pathways, describing the cause effect relationship between indicator and the AoP, should have a consistent theoretical foundation so the inventory results can be associated with a predictable damage or benefit to the AoP. This article uses two concrete examples from the work on SLCA to analyse to what extent this is the case in current practice. One considers whether indicators included in SLCA approaches can validly assess impacts on the well-being of the stakeholder, whereas the other example addresses whether the ‘incidence of child labour’ is a valid measure for impacts on the AoPs.

Materials and methods: The theoretical basis for the impact pathway between the relevant indicators and the AoPs is analysed drawing on research from relevant scientific fields.

Results:   The examples show a lack of valid impact pathways in both examples. The first example shows that depending on the definition of ‘well-being’, the assessment of impacts on well-being of the stakeholder cannot be performed exclusively with the type of indicators which are presently used in SLCA approaches. The second example shows that the mere fact that a child is working tells little about how this may damage or benefit the AoPs, implying that the normally used indicator; ‘incidence of child labour’ lacks validity in relation to predicting damage or benefit on the AoPs of SLCA.

Discussion: New indicators are proposed to mitigate the problem of invalid impact pathways. However, several problems arise relating to difficulties in getting data, the usability of the new indicators in management situations, and, in relation to example one, boundary setting issues.

Conclusions: The article shows that it is possible to assess the validity of the impact pathways in SLCA. It thereby point to the possibility of utilising the same framework that underpins the environmental LCA in this regard. It also shows that in relation to both of the specific examples investigated, the validity of the impact pathways may be improved by adopting other indicators, which does, however, come with a considerable ‘price’.

Recommendations and perspectives: It is argued that there is a need for analysing impact pathways of other impact categories often included in SLCA in order to establish indicators that better reflect actual damage or benefit to the AoPs.

Parent management training, comorbidity, and treatment of children with oppositional defiant disorder

This study found that Parent Management Training was a successful treatment for promary school aged children who were referred to a mental health clinic and diagnosed with Oppositional Defiant Disorder. The positive outcome was not affected by the child having comorbid disorders. These findings have relevance to the clinical field.

Family breakdown, the best interests of the child concept, and the legal system

It appears that the legal system's response to the issues relating to family breakdown and "the best interests of the child" concept can sometimes be inadequate. There also appears to a lack of consistency with regards to enforcing the best interests of the child concept in legal proceedings concerning children.

Relationship between childhood abuse and psychosexual adjustment in adult women

Study 1 found that poor attachment relationships, dysfunctional family environments, re-victimisation experiences and poor coping skills contibute towards mental health problems as well as the child abuse experiences. Study 2 implemented a therapy program that demonstrated an improvement in the sexual response of women who experienced childhood sexual assault.

Manualised treatment and dropout : a study of parent training

Parents who dropped out of manualised parent training programs for children with externalising behaviour disorders were interviewed retrospectively and compared prospectively with parents who continued in these programs. Parents who dropped out tended to feel more overwhelmed by their situation, because their child's behaviour problems were more severe, they had single parent status or had more than one child with difficulties.

Shared parenting

The thesis addresses shared parenting, an arrangement which emphasises the equal responsibility of both parents for children after separation, which is often assumed to ameliorate the supposed negative effects of parental separation. This study found that from children's perspective, the most important consideration was not the type of family they lived in but rather the quality of their relationship with each parent that impacted on their emotional adjustment. The portfolio focuses on the challenge of dealing with allegations of child sexual abuse in the context of the Family Court. The comples issues involved in these types of cases are illustrated by four case studies.

Child-focused and child-inclusive divorce mediation : comparatice outcomes from a prospective study of postseparation adjustment

This study compared outcomes over 1 year for two groups of separated parents, who attended two different forms of brief therapeutic mediation for entrenched parenting disputes. The two interventions each targeted psychological resolution of parental conflict, enhanced parental reflective function, and associated reduction of distress for their children. The child-focused (CF) intervention actively supported parents to consider the needs of their children, but without any direct involvement of the children, while the child-inclusive (CI) intervention incorporated separate consultation by a specialist with the children in each family, and consideration of their concerns with parents in the mediation forum. Repeated measures at baseline, 3 months, and 1 year postintervention explored changes over time and across treatments in conflict management, subjective distress, and relationship quality for all family members. Enduring reduction in levels of conflict and improved management of disputes, as reported by parents and children, occurred for both treatment groups in the year after mediation. The CI intervention had several impacts not evident in the other treatment group, related to relationship improvements and psychological well-being. These effects were strongest for fathers and children. Agreements reached by the CI group were significantly more durable, and the parents in this group were half as likely to instigate new litigation over parenting matters in the year after mediation as were the CF parents. The article explores the potential of CI divorce mediation to not only safely include many children in family law matters related to them, but also to promote their developmental recovery from high-conflict separation, through enhanced emotional availability of their parents.

Child focused and child inclusive family law dispute resolution : one year findings from a prospective study of outcomes

This prospective study compared outcomes over 1 year for two groups of separated parents, who attended mediation about their entrenched parenting disputes. The two treatments studied both aimed to improve the psychological resolution of parental conflict with associated reduction of distress for their children. The Child Focused intervention prioritised thought about the needs of children in high conflict divorce, but without any direct involvement of the children, while the Child Inclusive intervention incorporated separate consultation by a specialist with the children in each family, and consideration of their concerns with parents in the mediation forum. Measures were collected from parents and children prior to mediation commencing, and again three and twelve months after the conclusion of mediation. Significant and enduring reduction in levels of conflict and improved management of disputes occurred for both treatment groups in the year after mediation. Across all ages, children in both interventions perceived less frequent and intense conflict between their parents and better resolution of it, with a significant lowering of their related distress. The Child Inclusive intervention showed a number of independent effects not evident in the other treatment group, related to relationship improvements and psychological wellbeing. These effects were strongest for fathers and children. Agreements reached by the Child Inclusive group were significantly more durable and workable over the year, and these parents were half as likely to instigate new litigation over parenting matters in the year after mediation than were the Child Focused parents. The article considers possible mechanisms of change underpinning these outcomes.

Diversity, tradition and family : Australian same-sex attracted parents and their families

This paper describes the diversity of family forms within a sample of 455 families parented by same-sex couples and same-sex attracted sole parents from Australia and New Zealand. Around one-third of this sample had conceived at least one of their children while in a previous heterosexual relationship. The remaining two-thirds had conceived at least one child within a same-sex relationship or while they were single. Among this group, the largest proportion was women who conceived using home-based self-insemination with a known donor. A smaller proportion of women had conceived through clinic-based insemination or assisted reproduction with a known or unknown donor. There were 60 male participants in the sample. Around 20% of these men were raising children they had conceived through a surrogacy arrangement; the rest had conceived their children within previous heterosexual relationships or through donor arrangements with single women or lesbians. Around 50% of participants described their family form in terms of a two-parent model, where they and their partner were their children's only parents. Around 34% were sharing care of their children with ex-partners, either a previous heterosexual (opposite sex) partner or a previous same-sex partner. Around 10% described themself as their child's sole parent. In large part, participants in this study were not creating radically new family formations, with around half of all participants describing their family in terms of a two-parent ‘nuclear’ model, albeit a model involving parents of the same gender. However, pathways to conception and/or parenthood did reflect nontraditional patterns.

Implicit theories and personality patterns in child-victim sex offenders

Research has suggested that child sex offenders hold thematically distinct cognitive distortions, which Ward and Keenan (1999) call Implicit Theories. The aim of this preliminary study was to investigate the relationship between offenders’ Implicit Theories and their personality related cognitions. The variables were measured using the Implicit Theory Questionnaire and Millon’s (1990) MCMI-III personality scales. Subjects were 28 male sex offenders against children serving a custodial sentence in New Zealand, who elected to participate in a treatment program. A majority of participants had personality scale scores that reached the clinical threshold. Results found that dependant, depressive and schizoidal personality patterns significantly correlated with Implicit Theories. Clinical and theoretical implications are discussed.

Call for research – the consuming child-in-context in unhealthy and unsustainable times

Childhood obesity is a highly complex issue with serious health and environmental implications. It has been postulated that young children (preschool-aged in particular) are able to internalise positive environmental beliefs. Applying a socioecological theoretical perspective, in this discussion paper we argue that although children may internalise such beliefs, they commonly behave in ways that contradict these beliefs as demonstrated by their consumer choices. The media directly influences these consumer choices and growing evidence suggests that media exposure (particularly commercial television viewing) may be a significant “player” in the prediction of childhood obesity. However, there is still debate as to whether childhood obesity is caused by digital media use per se or whether other factors mediate this relationship. Growing evidence suggests that researchers should examine whether different types of content have conflicting influences on a child’s consumer choices and, by extension, obesity. The extent to which young children connect their consumer choices and the sustainability of the product/s they consume with their overall health and wellbeing has not previously been researched. To these ends, we call for further research on this socioecological phenomenon among young children, particularly with respect to the influence of digital media use on a child’s consumer behaviours.

Striving for a good life : the good lives model applied to released child molesters

The good lives model (GLM) is a strengths-based approach to offender rehabilitation in which treatment aims to equip offenders with the skills and resources necessary to satisfy primary goods, or basic human values, in personally meaningful and socially acceptable ways. The aim of the present research was to explore the practical utility of the GLM with a sample of released child molesters, and investigate the relationship between primary goods attainment and overall re-entry conditions (in terms of accommodation, social support and employment). Semi-structured interviews were conducted with 16 child molesters at one, three and six months following their release from prison. As expected, participants endorsed the majority of GLM primary goods with high importance, and positive re-entry experiences were associated with increased goods attainment. Implications for clinicians, policy makers and society as a whole are discussed.

Maternal correlates of preschool child eating behaviours and body mass index : a cross-sectional study

To the authors’ knowledge, this is the first study to evaluate maternal child feeding practices, maternal parenting characteristics and mother-child interactions as cross-sectional predictors of child eating and/or weight within the one sample. Maternal pressure for her child to eat was a significant positive correlate of fussiness and a negative correlate of enjoyment. Maternal parenting warmth was associated negatively with child BMIz, while mother-child dysfunctional interaction was associated positively with child BMIz. Our findings suggest that childhood obesity research may be better informed by evaluating not just what mothers do (feeding practices) but also how they parent (parenting behaviours and interactions with their child). Longitudinal studies are needed to identify causal influences of parenting on preschool child eating and weight.

Early life stress and child temperament style as predictors of childhood anxiety and depressive symptoms : findings from the longitudinal study of Australian children

Objective. The purpose of this study was to determine whether the relationship between stressful infant environments and later childhood anxiety and depressive symptoms varies as a function of individual differences in temperament style.

Methods. Data was drawn fromthe Longitudinal Study of Australian Children (LSAC). This study examined 3425 infants assessed at three time points, at 1-year, at 2/3 years and at 4/5 years. Temperament was measured using a 12-item version of Toddler Temperament Scale (TTS) and was scored for reactive, avoidant, and impulsive dimensions. Logistic regression was used to model direct relationships and additive interactions between early life stress, temperament, and emotional symptoms at 4 years of age. Analyses were adjusted for socioeconomic status, parental education, andmarital status.

Results. Stressful family environments experienced in the infant’s first year of life (high versus low) and high reactive, avoidant, and impulsive temperament styles directly and independently predicted anxiety and depressive problems in children at 4 years of age. There was no evidence of interaction between temperament and family stress exposure.

Conclusions. Both infant temperament and stress exposures are independent and notable predictors of later anxiety and depressive problems in childhood. The risk relationship between stress exposure in infancy and childhood emotion problems did not vary as a function of infant temperament. Implications for preventive intervention and future research directions are discussed.